A Case-Control Study of Hip Fracture Surgery Timing and Mortality at an Academic Hospital: Day Surgery May Be Safer than Night Surgery
Time from hospital admission to operative intervention has been consistently demonstrated to have a significant impact on mortality. Nonetheless, the relationship between operative start time (day versus night) and associated mortality has not been thoroughly investigated. Methods: All patients who...
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doaj-05a41629f1844e9a90e92c720c9d80df2021-08-26T13:55:14ZengMDPI AGJournal of Clinical Medicine2077-03832021-08-01103538353810.3390/jcm10163538A Case-Control Study of Hip Fracture Surgery Timing and Mortality at an Academic Hospital: Day Surgery May Be Safer than Night SurgeryAlim F. Ramji0Maxwell T. Trudeau1Michael R. Mancini2Matthew R. LeVasseur3Adam D. Lindsay4Augustus D. Mazzocca5Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, CT 06030, USADepartment of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, CT 06030, USADepartment of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, CT 06030, USADepartment of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, CT 06030, USADepartment of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, CT 06030, USADepartment of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, CT 06030, USATime from hospital admission to operative intervention has been consistently demonstrated to have a significant impact on mortality. Nonetheless, the relationship between operative start time (day versus night) and associated mortality has not been thoroughly investigated. Methods: All patients who underwent hip fracture surgery at a single academic institution were retrospectively analyzed. Operative start times were dichotomized: (1) day operation—7 a.m. to 4 p.m.; (2) night operation—4 p.m. to 7 a.m. Outcomes between the two groups were evaluated. Results: Overall, 170 patients were included in this study. The average admission to operating room (OR) time was 26.0 ± 18.0 h, and 71.2% of cases were performed as a day operation. The overall 90-day mortality rate was 7.1% and was significantly higher for night operations (18.4% vs. 2.5%; <i>p</i> = 0.001). Following multivariable logistic regression analysis, only night operations were independently associated with 90-day mortality (aOR 8.91, 95% confidence interval 2.19–33.22; <i>p</i> = 0.002). Moreover, these patients were significantly more likely to return to the hospital within 50 days (34.7% vs. 19.0%; <i>p</i> = 0.029) and experience mortality prior to discharge (8.2% vs. 0.8%; <i>p</i> = 0.025). Notably, admission to OR time was not associated with in-hospital mortality (29.22 vs. 25.90 h; <i>p</i> = 0.685). Hip fracture surgery during daytime operative hours may minimize mortalities.https://www.mdpi.com/2077-0383/10/16/3538hip fracturesurgeryoperative start timedaynightmortality |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Alim F. Ramji Maxwell T. Trudeau Michael R. Mancini Matthew R. LeVasseur Adam D. Lindsay Augustus D. Mazzocca |
spellingShingle |
Alim F. Ramji Maxwell T. Trudeau Michael R. Mancini Matthew R. LeVasseur Adam D. Lindsay Augustus D. Mazzocca A Case-Control Study of Hip Fracture Surgery Timing and Mortality at an Academic Hospital: Day Surgery May Be Safer than Night Surgery Journal of Clinical Medicine hip fracture surgery operative start time day night mortality |
author_facet |
Alim F. Ramji Maxwell T. Trudeau Michael R. Mancini Matthew R. LeVasseur Adam D. Lindsay Augustus D. Mazzocca |
author_sort |
Alim F. Ramji |
title |
A Case-Control Study of Hip Fracture Surgery Timing and Mortality at an Academic Hospital: Day Surgery May Be Safer than Night Surgery |
title_short |
A Case-Control Study of Hip Fracture Surgery Timing and Mortality at an Academic Hospital: Day Surgery May Be Safer than Night Surgery |
title_full |
A Case-Control Study of Hip Fracture Surgery Timing and Mortality at an Academic Hospital: Day Surgery May Be Safer than Night Surgery |
title_fullStr |
A Case-Control Study of Hip Fracture Surgery Timing and Mortality at an Academic Hospital: Day Surgery May Be Safer than Night Surgery |
title_full_unstemmed |
A Case-Control Study of Hip Fracture Surgery Timing and Mortality at an Academic Hospital: Day Surgery May Be Safer than Night Surgery |
title_sort |
case-control study of hip fracture surgery timing and mortality at an academic hospital: day surgery may be safer than night surgery |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-08-01 |
description |
Time from hospital admission to operative intervention has been consistently demonstrated to have a significant impact on mortality. Nonetheless, the relationship between operative start time (day versus night) and associated mortality has not been thoroughly investigated. Methods: All patients who underwent hip fracture surgery at a single academic institution were retrospectively analyzed. Operative start times were dichotomized: (1) day operation—7 a.m. to 4 p.m.; (2) night operation—4 p.m. to 7 a.m. Outcomes between the two groups were evaluated. Results: Overall, 170 patients were included in this study. The average admission to operating room (OR) time was 26.0 ± 18.0 h, and 71.2% of cases were performed as a day operation. The overall 90-day mortality rate was 7.1% and was significantly higher for night operations (18.4% vs. 2.5%; <i>p</i> = 0.001). Following multivariable logistic regression analysis, only night operations were independently associated with 90-day mortality (aOR 8.91, 95% confidence interval 2.19–33.22; <i>p</i> = 0.002). Moreover, these patients were significantly more likely to return to the hospital within 50 days (34.7% vs. 19.0%; <i>p</i> = 0.029) and experience mortality prior to discharge (8.2% vs. 0.8%; <i>p</i> = 0.025). Notably, admission to OR time was not associated with in-hospital mortality (29.22 vs. 25.90 h; <i>p</i> = 0.685). Hip fracture surgery during daytime operative hours may minimize mortalities. |
topic |
hip fracture surgery operative start time day night mortality |
url |
https://www.mdpi.com/2077-0383/10/16/3538 |
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