TO STUDY THE OUTCOMES OF EARLY VS DELAYED SURGERY IN HIP FRACTURES IN THE ELDERLY IN TERMS OF HOSPITAL STAY, COMPLICATIONS AND MORTALITY
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Keywords
Hip fractures, complications, duration of hospital stay, mortality
Abstract
Objective: The present study aimed to compare the postoperative duration of stay, complications and mortality in patients undergoing surgery within and after 72 hours of the injury for hip fractures.
Materials and methods: The present study was a prospective, longitudinal and observational, hospital-based study undertaken in the Department of Orthopaedics, Bharati Hospital and Research Centre, Pune, from September 2022 – to April 2024. The study population included patients with hip fractures above the age of >60, with a sample size of 55. The study considered the date of injury, medical comorbidities, time taken for optimization, and surgery. All 55 patients were observed for complications or difficulties before and after the surgery. Well-written informed consent was taken from all the patients. Ethical Committee approval was obtained before commencing the study.
Results: The study included 55 patients with a mean age of 74.65 ± 7.58 years. A substantial proportion of patients (87.3%) experienced a delay of more than 72 hours (since the injury) before surgery, with only 12.7% receiving surgical intervention within 72 hours of the injury. The current study's analysis showed that there was no statistically significant difference in the duration of hospital stays between patients who underwent surgery within 72 hours and those who underwent surgery after 72 hours, with a p-value of 0.28, postoperative complications appeared evenly distributed regardless of the timing of surgery (p-value = 0.54) and no statistically significant difference in the comparison of mortality between the two groups as the p-value was 0.37.
Conclusion: While early surgical intervention appeared to reduce mortality rates, it did not significantly impact the length of hospital stay, the need for ambulatory support, or other complications. These findings suggest that while the timing of surgery is an important factor, other elements, such as the patient's overall health, pre-existing mobility status, and quality of postoperative care, play crucial roles in recovery and functional outcomes.
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Dr. Pranav Arora
Resident, Department of Orthopaedics, Bharati Vidyapeeth Deemed to be University Medical College and Hospital, Pune, India.
Dr. Gururaj R Joshi
Professor, Department of Orthopaedics, Bharati Vidyapeeth Deemed to be University Medical College and Hospital, Pune, India.