Earlier Surgery Offered Best Recovery for Fractured Hip

Seniors with hip fractures had better recovery chance with earliest possible surgery

(RxWiki News) A broken hip is an all too common injury for seniors and can lead to serious disability. Researchers are looking for ways to make recovery faster and safer for anyone requiring hip surgery.

Researchers think delaying surgery for a hip fracture may lead to a higher chance of major complications, such as a heart attack or stroke during recovery.

Over the course of a new study, researchers found that patients who waited 24 hours after diagnosis had a much higher rate of complications.

Finding ways to perform surgery sooner may make many people's recovery faster and smoother.

"Ask for assistance in situations where a fall might occur."

P.J. Devereaux, PhD, associate professor in the department of clinical epidemiology and biostatistics at McMasters University was the lead author of this study.

The study looked at 60 patients, 45 years of age or older, who had been diagnosed with a hip fracture. Half of the participants underwent surgery within six hours of the diagnosis while the second half had surgery 24 hours after the diagnosis.

Patients were randomly selected for the study during normal weekday, daytime working hours. Each patient’s data was collected and accessed by personnel who were unaware of the study. Patients' overall health was monitored for 30 days following surgery, with specific interest in major complications such as death, heart attack, pneumonia, blood clots, stroke or major bleeding events.

Patients were studied in one of two Canadian hospitals — Hamilton Health Sciences and St. Joseph’s Healthcare Hamilton — or Sancheti Institute for Orthopaedics and Rehabilitation in Pune, India.

Delays due to pre-surgery clearance issues and a lack of operating rooms create an average delay in performing surgery on a fractured hip of 24 hours. Seniors may have additional risks due to such delays and no study has looked directly at the impact of delays on overall health and recovery specific to this type of injury.

Of the patients receiving accelerated treatment, 30 percent experienced a major complication, while those receiving treatment in the standard time frame saw a 47 percent incident rate of these same complications.

Dr. Devereaux summed up the results, saying, “We believe that the shortest time possible to treatment may provide the greatest potential for benefit, as is the case in acute heart attack and stroke.”

Data collectors were deliberately not informed of the treatment timeline for an individual surgery but may have figured it out through paperwork related to the surgery. The impact of this likely did not matter, as delays occurred for accelerated patients and 24-hour patents were sometimes moved to the six-hour schedule.

These researchers are planning a larger more complete study for 2014.

This study was published on November 18 in Canadian Medical Association Journal.

The research was funded by an operating grant from the Academic Health Science Centres (AHSC) Alternative Funding Plan (AFP) Innovation Fund Grant of Ontario and an investigator grant from Octapharma Canada Incorporated.

Review Date: 
November 18, 2013