Effect of timing of surgery on postoperative complications and prognosis in elderly patients with hip fractures

Zuobin Zhuo¹Weijun Hong¹Guangxi Ma^2*

• ¹Pingyang Hospital of Wenzhou Medical University, Wenzhou, China
• ²Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou, China

Background：In clinical practice, there is no standardized criteria for the optimal timing of hip fracture surgery in the elderly, and there is much controversy. Objectives：To investigate the effect of timing of surgery on postoperative complications and prognosis in elderly patients with hip fractures. Methods：Retrospectively analyzed 636 elderly hip fracture patients over 65 years old. The patients were divided into early group (< 3 days), intermediate group (3-7 days) and late group (> 7 days) according to the time from fracture to surgery, and the three groups were compared with the postoperative in-hospital general conditions, the occurrence of complications, the efficacy and the prognosis. P<0.05 indicates that the difference is statistically significant. Results：Postoperative hospitalization was significantly shorter in the early group than in the intermediate and late groups (9.5 ± 4.2 d vs. 11.9 ± 3.7 d vs. 13.3 ± 4.5 d, P<0.05). The incidence of postoperative lung infection (2.7 % vs. 6.3 % vs. 8.4 %), deep vein thrombosis (3.9 % vs. 6.7 % vs. 11.6 %), stress ulcers (1.9 % vs. 3.6 % vs. 7.1 %), and pressure ulcers (2.3 % vs. 6.7 % vs. 7.7 %) was the lowest in the early group, followed by the intermediate group, and the highest in the late group (P<0.05). In-hospital mortality was lower in the early group than in the intermediate and late groups (3.5% vs. 8.0% vs. 10.3%). In addition, at one month postoperatively, Harris scores were significantly higher in the early group than in the intermediate group (87.1 ± 5.3 vs. 82.2 ± 5.6, P<0.001) and in the intermediate group than in the late group (82.2 ± 5.6 vs. 78.4 ± 5.0, P=0.008). At one year postoperatively, the mortality rate was lower in the early group than in the intermediate and late groups (2.4% vs. 6.8% vs. 7.2%). Conclusion：Early surgery reduces the incidence of postoperative complications in elderly hip fracture patients, shortens hospitalization time, facilitates early recovery of hip function, and reduces mortality within 1 year after surgery.