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The impact of operative timing on clinical outcomes in elderly hip fracture

2011-08-15王晓伟WangXiaoweiDeptOrthopSurgBeijingArmyGenHospBeijing100700ChinOrthop2010301211711174

外科研究与新技术 2011年2期

王晓伟(Wang Xiaowei,Dept Orthop Surg,Beijing Army Gen Hosp,Beijing 100700)…∥Chin J Orthop.-2010,30(12).-1171~1174

The impact of operative timing on clinical outcomes in elderly hip fracture

王晓伟(Wang Xiaowei,Dept Orthop Surg,Beijing Army Gen Hosp,Beijing 100700)…∥Chin J Orthop.-2010,30(12).-1171~1174

ObjectiveTo study the effect of operative timing on clinical outcomes in elderly hip fracture.MethodsTwo hundred sixty-seven patients with hip fracture were treated from July 2006 to May 2008.The patients who had an operation within two days(the early surgery group)were compared for the outcome with those who had an operation beyond two days(the late surgery group).Outcomes measured were mortality,post-operative complications,operative details,the comorbidity and the activities of daily living of patients.ResultsOne hundred and sixteen patients were included in the study.There were 45 cases in the early surgery group,including 13 males and 32 females.The patients ranged from sixtyfive to eighty-eight years old,with an average age of 78.76 years.While there were 71 patients in the late surgery group,including 24 males and 47 females.The patients ranged from sixty-six to one hundred and three years old,with an average age of 80.00 years.The demographic data of patients show no significant difference in two groups.There was no difference in intraoperative conditions such as anesthesia,amount of bleeding,type of fixation between two groups.Patients in early surgery group experienced shorter length of hospital stay,and fewer pulmonary complications.The mortality of early surgery group does not show a significant increase at discharge,6 month,12 month postoperatively compared to that of the late surgery group.However patients in the early surgery group show a significant increase of ADL scores at discharge,6 month postoperatively,but not at 12 month.ConclusionThe timing of surgery has an impact on clinical outcome in elderly hip fracture.Early surgery was associated with improved function in the first 6 month postoperatively,but not 12 months,but it was not associated with mortality.8 refs,4 tabs.

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