Surgical Time of Day Does Not Affect Outcome Following Hip Fracture Fixation

Julie A Switzer, Ryan E. Bennett, David M. Wright, Sandy Vang, Christopher P. Anderson, Andrea J. Vlasak, Steven R. Gammon

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Due to the need for medical optimization and congested operating room schedules, surgical repair is often performed at night. Studies have shown that work done at night increases complications. The primary aim of our study is to compare the rates of complications and 30-day mortality between 2 surgical times of day, daytime group (DTG, 07:00-15:59) and nighttime group (NTG, 16:00-06:59). Retrospective chart review from 2005 through 2010. Level 1 Trauma Center. 1443 patients with hip fracture, age ≥50 years with isolated injury and surgical treatment of the fracture. Thirty-day mortality and complications: myocardial infarction, cardiac event, stroke, central nervous system event, pneumonia, urinary tract infection, postoperative wound infection, and bleeding requiring transfusion of 3 or more red blood cell units. A total of 859 patients met the inclusion criteria; 668 patients in the DTG and 191 patients in the NTG. The 30-day mortality was 7.8%. The complication rate was 28%. No difference was found in 30-day mortality or complication rate based on the time of day the surgery was performed (P = 1.0 and P = .92, respectively). This remained unchanged when controlling for health status and surgical complexity. Age (odds ratio = 1.03/year), Charlson Comorbidity Index (CCI; odds ratio = 1.21), and American Society of Anesthesiologists (ASA; odds ratio = 1.85) score were predictive of adverse outcomes. Surgical time of day did not affect 30-day mortality or total number of complications. Age, ASA score, and CCI were associated with adverse outcomes.

Original languageEnglish (US)
Pages (from-to)109-116
Number of pages8
JournalGeriatric Orthopaedic Surgery & Rehabilitation
Volume4
Issue number4
DOIs
StatePublished - Jan 1 2013

Fingerprint

Fracture Fixation
Hip Fractures
Operative Time
Mortality
Odds Ratio
Surgical Wound Infection
Trauma Centers
Intraoperative Complications
Operating Rooms
Ambulatory Surgical Procedures
Urinary Tract Infections
Health Status
Comorbidity
Pneumonia
Appointments and Schedules
Central Nervous System
Erythrocytes
Stroke
Myocardial Infarction
Hemorrhage

Keywords

  • geriatric
  • hip fracture
  • outcomes
  • surgery time
  • time of day
  • time to operation

Cite this

Switzer, J. A., Bennett, R. E., Wright, D. M., Vang, S., Anderson, C. P., Vlasak, A. J., & Gammon, S. R. (2013). Surgical Time of Day Does Not Affect Outcome Following Hip Fracture Fixation. Geriatric Orthopaedic Surgery & Rehabilitation, 4(4), 109-116. https://doi.org/10.1177/2151458513518344

Surgical Time of Day Does Not Affect Outcome Following Hip Fracture Fixation. / Switzer, Julie A; Bennett, Ryan E.; Wright, David M.; Vang, Sandy; Anderson, Christopher P.; Vlasak, Andrea J.; Gammon, Steven R.

In: Geriatric Orthopaedic Surgery & Rehabilitation, Vol. 4, No. 4, 01.01.2013, p. 109-116.

Research output: Contribution to journalArticle

Switzer, Julie A ; Bennett, Ryan E. ; Wright, David M. ; Vang, Sandy ; Anderson, Christopher P. ; Vlasak, Andrea J. ; Gammon, Steven R. / Surgical Time of Day Does Not Affect Outcome Following Hip Fracture Fixation. In: Geriatric Orthopaedic Surgery & Rehabilitation. 2013 ; Vol. 4, No. 4. pp. 109-116.
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