Abstract
The objective of this study was to analyze whether a delay in time from admission until surgical treatment increased the mortality rate for patients with a closed hip fracture. We used the day of the week of admission as an instrumental variable to pseudorandomize patients. We analyzed 18,209 Medicare recipients who were 65 years of age or older and had surgical treatment for a closed hip fracture. Patients for whom the delay between admission and surgery was 2 days or more had a 17% higher chance of dying by Day 30. Using instrumental variables analysis, we found a similar 15% increased risk of mortality in patients with delays until surgery of 2 or more days. Based on these results, we found that a delay of 2 or more days significantly increased the mortality rate. This suggests that delay to surgery independently affects mortality, therefore additional study on the effect of smaller delays on outcome is needed.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 294-301 |
| Number of pages | 8 |
| Journal | Clinical orthopaedics and related research |
| Issue number | 428 |
| DOIs | |
| State | Published - Jan 1 2004 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Surgery
- Orthopedics and Sports Medicine
Cite this
The 2004 Marshall Urist Award : Delays until surgery after hip fracture increases mortality. / McGuire, Kevin J.; Bernstein, Joseph; Polsky, Daniel E.; Silber, Jeffrey H.
In: Clinical orthopaedics and related research, No. 428, 01.01.2004, p. 294-301.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The 2004 Marshall Urist Award
T2 - Delays until surgery after hip fracture increases mortality
AU - McGuire, Kevin J.
AU - Bernstein, Joseph
AU - Polsky, Daniel E.
AU - Silber, Jeffrey H.
PY - 2004/1/1
Y1 - 2004/1/1
N2 - The objective of this study was to analyze whether a delay in time from admission until surgical treatment increased the mortality rate for patients with a closed hip fracture. We used the day of the week of admission as an instrumental variable to pseudorandomize patients. We analyzed 18,209 Medicare recipients who were 65 years of age or older and had surgical treatment for a closed hip fracture. Patients for whom the delay between admission and surgery was 2 days or more had a 17% higher chance of dying by Day 30. Using instrumental variables analysis, we found a similar 15% increased risk of mortality in patients with delays until surgery of 2 or more days. Based on these results, we found that a delay of 2 or more days significantly increased the mortality rate. This suggests that delay to surgery independently affects mortality, therefore additional study on the effect of smaller delays on outcome is needed.
AB - The objective of this study was to analyze whether a delay in time from admission until surgical treatment increased the mortality rate for patients with a closed hip fracture. We used the day of the week of admission as an instrumental variable to pseudorandomize patients. We analyzed 18,209 Medicare recipients who were 65 years of age or older and had surgical treatment for a closed hip fracture. Patients for whom the delay between admission and surgery was 2 days or more had a 17% higher chance of dying by Day 30. Using instrumental variables analysis, we found a similar 15% increased risk of mortality in patients with delays until surgery of 2 or more days. Based on these results, we found that a delay of 2 or more days significantly increased the mortality rate. This suggests that delay to surgery independently affects mortality, therefore additional study on the effect of smaller delays on outcome is needed.
UR - http://www.scopus.com/inward/record.url?scp=8644265123&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=8644265123&partnerID=8YFLogxK
U2 - 10.1097/01.blo.0000146743.28925.1c
DO - 10.1097/01.blo.0000146743.28925.1c
M3 - Article
C2 - 15534555
AN - SCOPUS:8644265123
SP - 294
EP - 301
JO - Clinical Orthopaedics and Related Research
JF - Clinical Orthopaedics and Related Research
SN - 0009-921X
IS - 428
ER -