The sun should not set twice before hip fracture repair: New
Optimal timing to reduce mortality after hip surgery in medically stable older patients is on the day of admission or the following day, according to a large study published in Canadian Medical Association Journal.

Researchers from Canada, the United Kingdom and the United States analyzed data from the Canadian Institute for Health Information on nearly 140 000 patients aged 65 years or older who had surgery for a first-time hip fracture at 144 hospitals in Canada (38 teaching and 106 community hospitals). The majority (74%) were women and almost half were older than 85 years.

The authors asked how postoperative mortality would change if the same patient population were to undergo surgery on the day of admission, on inpatient day 2, day 3, or after day 3, as would be done in a randomized trial. Previous studies had, in contrast, compared mortality among patients with various observed times to surgery.

The authors project an additional 11 deaths for every 1000 hip fracture surgeries if all surgeries in medically stable patients were done after inpatient day 3 instead of on admission day.

"Our findings allow us to infer a critical point for the timing of hip fracture repair. We suggest that clinicians, administrators, and policy-makers 'not let the sun set twice' on medically stable older adults before their hip fracture repair," the authors have said.

Read more here: https://www.eurekalert.org/pub_releases/2018-08/cmaj-tss073118.php
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