Early Operation on Patients with a Hip Fracture Improved the Ability to Return to Independent Living

Al-ani, Amer N.; Samuelsson, Bodil; Tidermark, Jan; Norling, Åsa; Ekström, Wilhelmina; Cederhoim, Tommy; Hedström, Margareta
July 2008
Journal of Bone & Joint Surgery, American Volume;Jul2008, Vol. 90-A Issue 7, p1436
Academic Journal
Background: The outcome for many patients with a hip fracture remains poor. The aim of the present study was to investigate whether the timing of surgery in such patients could influence the short-term clinical outcome. Methods: We included 850 consecutive patients with a hip fracture who were admitted to the hospital during one year in a prospective study. Three cutoff limits for a comparison of early and late operation were defined. The outcome (the ability to return to independent living, risk for the development of pressure ulcers, length of the hospital stay, and mortality rate) for patients who had an operation within twenty-four, thirty-six, and forty-eight hours was compared with the outcome for those who had an operation at a later time. Results: Patients who had the operation more than thirty-six and forty-eight hours after admission were less likely to return to independent living within four months (odds ratio, 0.44 and 0.33, respectively), whereas there was no significant difference with use of the twenty-four-hour cutoff limit. The incidence of pressure ulcers in the groups that had the operation later was increased at all three cutoff limits (a delay of more than twenty-four hours, more than thirty- six hours, and more than forty-eight hours) (odds ratio, 2.19, 3.42, and 4.34, respectively). The length of hospitalization was also increased in the groups that had the later operation (median, fourteen compared with eighteen days, fifteen compared with nineteen days, and fifteen compared with twenty-one days, respectively) (p < 0.001 for all comparisons). The importance of surgical timing remained significant after adjusting for several possible confounders (p < 0.05). Conclusions: Early compared with late operative treatment of patients with a hip fracture is associated with an improved ability to return to independent living, a reduced risk for the development of pressure ulcers, and a shortened hospital stay.


Related Articles

  • A 4-Week Neuromuscular Training Program and Gait Patterns at the Ankle Joint. Coughlan, Garrett; Caulfield, Brian // Journal of Athletic Training (National Athletic Trainers' Associ;Jan-Mar2007, Vol. 42 Issue 1, p51 

    Context: Previous research into the rehabilitation of ankle sprains has primarily focused on outcome measures that do not replicate functional activities, thus making it difficult to extrapolate the results relative to the weight-bearing conditions under which most ankle sprains occur....

  • Preoperative Clinical Status but not Waiting Time Predicts In-Hospital Outcomes of Surgery in Patients with Left Main Coronary Artery Stenosis. Sari, Ibrahim; Acar, Zubeyir; Nurkalem, Zekeriya; Uslu, Nevzat; Davutoglu, Vedat; Ates, Mehmet; Ozer, Orhan; Eren, Mehmet; Aksoy, Mehmet // Tohoku Journal of Experimental Medicine;Oct2007, Vol. 213 Issue 2, p173 

    Contoversy exists about the optimal operation time of the patients with left main coronary artery (LMCA) stenosis. We therefore, aimed to investigate the effect of waiting time on in-hospital morbidity and mortality in patients with LMCA stenosis and identify the risk factors associated with...

  • Does Computer-Assisted Surgery Improve Accuracy and Decrease the Learning Curve in Hip Resurfacing? A Radiographic Analysis. Seyler, Thorsten M.; Lai, Lawrence P.; Sprinkle, Denise I.; Ward, William G.; Jinnah, Riyaz H. // Journal of Bone & Joint Surgery, American Volume;Aug2008 Supplement 3, Vol. 90-A, p71 

    Background: Hip resurfacing is a technically demanding procedure in which accurate positioning of the femoral component is critical to the avoidance of early implant failures. The purpose of this study was to assess the accuracy of computer-assisted placement of the femoral component and to...

  • Position of Hip Resurfacing Component Affects Strain and Resistance to Fracture in the Femoral Neck. Vail, Thomas Parker; Glisson, Richard R.; Dominguez, David E.; Kitaoka, Kenichi; Ottaviano, Danielle // Journal of Bone & Joint Surgery, American Volume;Sep2008, Vol. 90-A Issue 9, p1951 

    Background: Retrieval studies have suggested that the cause of femoral implant failure after metal-on-metal hip resurfacing is multifactorial. Both varus positioning of the femoral component and notching of the superior part of the femoral neck have been associated with femoral component...

  • Social deprivation and prognostic benefits of cardiac surgery: observational study of 44902 patients from five hospitals over 10 years. Pagano, D.; Freemantle, N.; Bridgewater, B.; Howell, N.; Ray, D.; Jackson, M.; Fabri, B.M.; Au, J.; Keenan, D.; Kirkup, B.; Keogh, B.E. // BMJ: British Medical Journal (Overseas & Retired Doctors Edition;4/25/2009, Vol. 338 Issue 7701, p989 

    Objective To assess the effects of social deprivation on survival after cardiac surgery and to examine the influence of potentially modifiable risk factors. Design Analysis of prospectively collected data. Prognostic models used to examine the additional effect of social deprivation on the end...

  • Juice up your joints. Henry, Sara J.; Rao, Linda // Prevention;May94, Vol. 46 Issue 5, p82 

    Provides information on preventing and dealing with pain, stiffness and other discomforts in joints. Why joints become painful; Rejuvenating the joints; Exercises to develop optimum flexibility and head off problems of overuse. INSETS: Take the click out of this joint (temporomandibular...

  • Managing AC joint injuries. Pappas, Arthur M.; Rubin, Aaron // Physician & Sportsmedicine;Jun98, Vol. 26 Issue 6, p36 

    Focuses on acromioclavicular (AC) joint injuries, while discussing injury mechanisms and classification. Evaluation and treatment of the six types of acute injuries, chronic dislocations and sprains, and associated coracoid fractures; Classification of acute AC joint injuries; Identification of...

  • Ask Dr. Carolyn Dean... Dean, Carolyn // Health News & Review;Summer95, p4 

    Presents an excerpt from the book `Dr. Carolyn Dean's Complementary Natural Prescriptions For Common Ailments,' by Carolyn Dean, about alternative treatment for joint pain. Diagnosis of arthritis; Allergies as a cause of joint symptoms.

  • The way to wrap. Wolverton, Brad; Fiske, Susan Festa // Tennis;Dec97, Vol. 33 Issue 8, p18 

    Introduces the instant ice pack called Wrapz which is ideal for healing injured joints mostly experienced by athletes. Reusability as either a cold or hot pack.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics