Saturday, April 29, 2006

Timing of hip fracture surgery

In this observational study of 129,522 patients admitted with femoral neck fracture, surgery delay of more than one day was associated with increased mortality with an odds ratio of 1.27 (1.23-1.32) after adjustment for comorbidity.

Hospitalists are often called on to optimize medical management of hip fracture patients prior to surgery. Physiologic disturbances and laboratory abnormalities must be addressed as fully as possible, but these and other recent data suggest that the time window is short and that lengthy preparation has diminishing returns.

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