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The effect of surgical timing on the outcome of patients with neck of femur fracture

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Aims

To investigate the effect of surgical timing (in hours versus after hours and weekdays versus weekends) on the outcome of patients with neck of femur fracture.

Methods

Patients who were admitted to a single tertiary referral hospital for surgical management of femoral neck fractures over a continuous period from 1/11/2002 to 12/7/2012 were identified from medical records and the operating theatre database.

Results

A consecutive series of 2334 patients were included in the study. Of the patients who underwent surgery during the weekday and during usual hours, 18 % (207/1135) experienced an adverse event, compared to 16 % (193/1199) outside of these times. The difference between the two groups was not significant (p = 0.17). The same conclusion was made for the comparison between those who had surgery during the week with those who had surgery on the weekend (17 %, 267/1546 and 17 %, 133/788, respectively, p > 0.05). The proportion of patients who underwent surgery during hours that experienced an adverse event was significantly higher than those undergoing surgery out of hours (18 %, 327/1789 and 13 %, 73/545, respectively, p = 0.0081). When adjusted for age, ASA score and pre-operative stay, there was no statistical difference between those different sub-groups.

Conclusions

There was no difference in the rates of adverse events between patients who had surgery during hours and weekdays with those who had surgery after hours or weekends. The careful selection of patients with appropriate hospital staff, resources and adequate theatre access, surgery during after hours and weekends may be safely considered to prevent a delay in surgical treatment for patient with neck of femur fracture.

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Acknowledgments

We acknowledge A. Prof David Bainbridge for providing data and assistance for the study.

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Authors and Affiliations

  1. Barwon Health, Department of Orthopaedic Surgery, Geelong Hospital, 292-392 Ryrie Street, Geelong, VIC, 3220, Australia

    Aik Honn Lim & Richard Page

  2. Barwon Health Biostatistics Unit, School of Medicine, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia

    Stephen Lane

  3. School of Medicine, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia

    Richard Page

  4. Barwon Orthopaedic Research Unit, Barwon Health, Geelong, VIC, 3220, Australia

    Richard Page

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  1. Aik Honn Lim
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  2. Stephen Lane
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Correspondence to Aik Honn Lim.

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The authors declare that they have no conflict of interest.

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Lim, A.H., Lane, S. & Page, R. The effect of surgical timing on the outcome of patients with neck of femur fracture. Arch Orthop Trauma Surg 135, 1497–1502 (2015). https://doi.org/10.1007/s00402-015-2303-x

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  • DOI: https://doi.org/10.1007/s00402-015-2303-x

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