医学
髋部骨折
置信区间
优势比
外科
美国麻醉师学会
挪威语
相对风险
内科学
骨质疏松症
语言学
哲学
作者
Sunniva Leer-Salvesen,Lars B. Engesæter,Eva Dybvik,Ove Furnes,Torbjørn Berge Kristensen,Jan‐Erik Gjertsen
出处
期刊:The bone & joint journal
[British Editorial Society of Bone and Joint Surgery]
日期:2019-09-01
卷期号:101-B (9): 1129-1137
被引量:85
标识
DOI:10.1302/0301-620x.101b9.bjj-2019-0295.r1
摘要
Aims The aim of this study was to investigate mortality and risk of intraoperative medical complications depending on delay to hip fracture surgery by using data from the Norwegian Hip Fracture Register (NHFR) and the Norwegian Patient Registry (NPR). Patients and Methods A total of 83 727 hip fractures were reported to the NHFR between 2008 and 2017. Pathological fractures, unspecified type of fractures or treatment, patients less than 50 years of age, unknown delay to surgery, and delays to surgery of greater than four days were excluded. We studied total delay (fracture to surgery, n = 38 754) and hospital delay (admission to surgery, n = 73 557). Cox regression analyses were performed to calculate relative risks (RRs) adjusted for sex, age, American Society of Anesthesiologists (ASA) classification, type of surgery, and type of fracture. Odds ratio (OR) was calculated for intraoperative medical complications. We compared delays of 12 hours or less, 13 to 24 hours, 25 to 36 hours, 37 to 48 hours, and more than 48 hours. Results Mortality remained unchanged when total delay was less than 48 hours. Total delay exceeding 48 hours was associated with increased three-day mortality (RR 1.69, 95% confidence interval (CI) 1.23 to 2.34; p = 0.001) and one-year mortality (RR 1.06, 95% CI 1.04 to 1.22; p = 0.003). More intraoperative medical complications were reported when hospital delay exceeded 24 hours. Conclusion Hospitals should operate on patients within 48 hours after fracture to reduce mortality and intraoperative complications. Cite this article: Bone Joint J 2019;101-B:1129–1137.
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