In adult patients undergoing surgery for femoral fracture, the risk of complications and death within 30 days increases with the duration of the waiting period of the operation. Waiting time of 24 hours may represent a threshold value that indicates a higher risk, according to a study published in the journal JAMA.
A group of researchers analyzed data from patients who underwent surgery in connection with a femur fracture from April 2009 to March 2014, 72 hospitals of the province of Ontario, Canada. After exclusion of patients with history of femoral fracture in history, with missing data and other factors, the final cohort included 42 230. The average age of participants was 80.1 years; 70.5% of women. Mean time to operation for 38.8 hours.
The results showed that the total mortality within 30 days was 7%. However, the risk of complications increased when the operation timeout exceeded 24 hours, regardless of the considered complications. Patients waiting for surgery more than 24 hours had a significantly higher risk of death within 30 days compared with those who had surgery before (898 (6.5%) and 790 (5,8%), respectively).
Under the guidance of experts in the USA and Canada of surgical intervention after fracture of the femur is recommended within 48 hours, the British guide guide is 36 hours. The researchers found that the commitment to these recommendations varies from 14.7 to 95.3 per cent.
“Focus on the operation within 24 hours is a significant change in clinical practice, as 66% of patients participated in the study was not carried out surgery during this time,” said the authors.
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