Delayed Admission Time and Its Reason in Patients with Geriatric Hip Fracture
DOI:
https://doi.org/10.56929/jseaortho-022-0163Keywords:
geriatric hip fracture, delay time, admission time, morbidityAbstract
Purpose: Geriatric hip fractures are common. Surgical treatment is generally required to achieve a good quality of life. It was reported that a delayed time from injury to treatment leads to poor outcomes. We aimed to determine the time interval from injury to hospital admission in patients with geriatric hip fractures and explore the reasons for delay.
Methods: Information on geriatric hip fracture patients who received treatment at our hospital from November 2016 to October 2020 was extracted from medical records. The average delay time was analyzed and reported. The reasons for delay were collected from patients who were not referred from other hospitals and had a time interval from injury to admission of more than 24 h.
Results: The median time interval was 0.38 days, and 127 (32%) visited the hospital more than 24 h later. In patients not referred from other hospitals, the most common cause of delay was that patients overlooked the possibility of bone fractures (58%). Other reasons included unavailable transportation (20%), missed diagnosis from other hospitals (11%), inability to afford the transportation cost (7%), and inability to talk and/or caregivers did not notice the injury (4%).
Conclusions: Almost one-third of geriatric hip fracture patients had a time from injury to admission of more than 24 h. Knowing the reason for delay and determining a solution to minimize this time interval may improve treatment quality. This information demonstrates that public and healthcare providers should pay attention to elderly patients with a history of fall injury.
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References
Hefley Jr FG, Nelson CL, Puskarich-May CL. Effect of delayed admission to the hospital on the preoperative prevalence of deep-vein thrombosis associated with fractures about the hip. J Bone Joint Surg Am 1996;78:581-3. DOI: https://doi.org/10.2106/00004623-199604000-00012
Maheshwari K, Planchard J, You J, et al. Early surgery confers 1-year mortality benefit in hip-fracture patients. J Orthop Trauma 2018;32:105-10. DOI: https://doi.org/10.1097/BOT.0000000000001043
Moran CG, Wenn RT, Sikand M, et al. Early mortality after hip fracture: is delay before surgery important?. J Bone Joint Surg Am 2005;87:483-9. DOI: https://doi.org/10.2106/JBJS.D.01796
Rodriguez-Fernandez P, Adarraga-Cansino D, Carpintero P. Effects of delayed hip fracture surgery on mortality and morbidity in elderly patients. Clin Orthop Relat Res 2011;469:3218-21. DOI: https://doi.org/10.1007/s11999-010-1756-z
Espinosa KA, Gélvez AG, Torres LP, et al. Pre-operative factors associated with increased mortality in elderly patients with a hip fracture: A cohort study in a developing country. Injury 2018;49:1162-8. DOI: https://doi.org/10.1016/j.injury.2018.04.007
Khan SK, Kalra S, Khanna A, et al. Timing of surgery for hip fractures: a systematic review of 52 published studies involving 291,413 patients. Injury 2009;40:692-7. DOI: https://doi.org/10.1016/j.injury.2009.01.010
Moja L, Piatti A, Pecoraro V, et al. Timing matters in hip fracture surgery: patients operated within 48 hours have better outcomes. A meta-analysis and meta-regression of over 190,000 patients. PLoS One 2012;7:e46175. DOI: https://doi.org/10.1371/journal.pone.0046175
Orosz GM, Hannan EL, Magaziner J, et al. Hip fracture in the older patient: reasons for delay in hospitalization and timing of surgical repair. J Am Geriatr Soc 2002;50:1336-40. DOI: https://doi.org/10.1046/j.1532-5415.2002.50353.x
Vidal EIO, Moreira-Filho DC, Pinheiro RS, et al. Delay from fracture to hospital admission: a new risk factor for hip fracture mortality?. Osteoporos Int 2012;23:2847-53. DOI: https://doi.org/10.1007/s00198-012-1917-x
Li Y, Lin J, Wang P, et al. Effect of time factors on the mortality in brittle hip fracture. J Orthop Surg Res 2014;9:37. DOI: https://doi.org/10.1186/1749-799X-9-37
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