Early surgery (≤48h) in patients ≥80 with hip fractures reduced 1-year mortality (11.6% vs 28.0%) and 2-year mortality (36.0% vs 50.7%), plus fewer complications.
Does early surgery reduce mortality and complications in super-aged patients (≥ 80 years) with hip fractures?
Early surgical intervention (≤ 48 hours) for hip fractures in patients aged 80 years and older is associated with improved 1- and 2-year survival, fewer complications, and shorter hospital stays.
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ABSTRACT Objective The global aging population has led to a significant increase in hip fractures among elderly patients, posing substantial clinical challenges. While early surgical intervention is widely advocated, its impact on postoperative complications and mortality in super‐aged (≥ 80 years) hip fracture patients remains controversial. This study aimed to evaluate the association between early surgery and clinical outcomes in this population. Methods We conducted a retrospective cohort study of patients aged ≥ 80 years who underwent hip fracture surgery at a single‐center orthopedic trauma center between January 2018 and November 2021. Participants were stratified into early surgery (≤ 48 h post‐admission) and non‐early surgery groups. Propensity score matching (PSM) was employed to control for confounding variables. Primary outcomes included 30‐day, 90‐day, 1‐year, and 2‐year mortality rates. Secondary outcomes encompassed perioperative transfusion rates, postoperative complications, hospital length of stay (LOS), and hospitalization costs. Results After PSM, a total of 300 patients were included. Compared with the non‐early surgery group, the early surgery group had lower 1‐year (11.6% vs. 28.0%, p < 0.001) and 2‐year (36.0% vs. 50.7%, p = 0.010) postoperative mortality rates, a lower perioperative blood transfusion rate (32.7% vs. 53.3%, p < 0.001), lower incidences of postoperative pneumonia (15.3% vs. 29.3%, p = 0.004) and delirium (14.0% vs. 36.0%, p < 0.001), a shorter length of stay 8.6 days (7.5, 11.2) vs. 11.6 days (9.7, 14.9), p < 0.001, and lower hospitalization expenses 54,336 ¥ (48,965, 64,532) vs. 61,616 ¥ (50,758, 74,484), p = 0.001. The serum albumin level at discharge in the early surgery group was higher (33.4 (31.6, 35.4) vs. 32.6 (30.7, 34.9), p = 0.039). Kaplan–Meier survival curve analysis showed that the all‐cause mortality rate in the non‐early surgery group increased (Log Rank p = 0.0066). Multivariate Cox analysis showed that age, BMI, admission hemoglobin, and non‐early surgery were risk factors for 2‐year mortality. Conclusion Early surgical intervention for hip fractures in super‐aged patients is associated with improved survival, reduced complications, and better resource utilization. These findings support the implementation of protocols to minimize preoperative delays in this vulnerable population.
Xie et al. (Tue,) reported a other. Early surgery (≤48h) in patients ≥80 with hip fractures reduced 1-year mortality (11.6% vs 28.0%) and 2-year mortality (36.0% vs 50.7%), plus fewer complications.