Timing of Hip-fracture Surgery in Elderly Patients: Literature Review and Recommendations
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
The incidence of hip fractures is rapidly increasing with an aging population and is now one of the most important health concerns worldwide due to a high mortality rate. The effect of delayed surgery on postoperative outcomes has been widely discussed. Although various treatment guidelines for hip fractures in the elderly exist, most institutions recommend that operations are conducted as soon as possible to help achieve the most favorable outcomes. While opinions differ on the relationship between delayed surgery and postoperative mortality, a strong association between earlier surgery and improvement in postoperative outcomes (e.g., length of hospital stay, bedsore occurrence, return to an independent lifestyle), has been reported. Taken together, performing operations for hip fractures in the elderly within 48 hours of admission appears to be best practice. Importantly, however, existing evidence is based primarily on observational studies which are susceptible to inherent bias. Here, we share the results of a literature search to summarize data that helps inform the most appropriate surgical timing for hip fractures in the elderly and the effects of delayed surgery on postoperative outcome. In addition, we expect to be able to provide a more accurate basis for these correlations through a largescale randomized controlled trial in the future and to present data supporting recommendations for appropriate surgical timing.
Abstract
The incidence of hip fractures is rapidly increasing with an aging population and is now one of the most important health concerns worldwide due to a high mortality rate. The effect of delayed surgery on postoperative outcomes has been widely discussed. Although various treatment guidelines for hip fractures in the elderly exist, most institutions recommend that operations are conducted as soon as possible to help achieve the most favorable outcomes. While opinions differ on the relationship between delayed surgery and postoperative mortality, a strong association between earlier surgery and improvement in postoperative outcomes (e.g., length of hospital stay, bedsore occurrence, return to an independent lifestyle), has been reported. Taken together, performing operations for hip fractures in the elderly within 48 hours of admission appears to be best practice. Importantly, however, existing evidence is based primarily on observational studies which are susceptible to inherent bias. Here, we share the results of a literature search to summarize data that helps inform the most appropriate surgical timing for hip fractures in the elderly and the effects of delayed surgery on postoperative outcome. In addition, we expect to be able to provide a more accurate basis for these correlations through a largescale randomized controlled trial in the future and to present data supporting recommendations for appropriate surgical timing.
참고문헌 (31)
- Leal J, "REFReSH study group. Impact of hip fracture on hospital care costs:a population-based study", Osteoporos Int, 27, pp.549~558 (2016)
- Marques A, "Portuguese Working Group for the Study of the Burden of Hip Fractures in Portugal. The burden of osteoporotic hip fractures in Portugal: costs, health related quality of life and mortality", Osteoporos Int, 26, pp.2623~2630 (2015)
- Tan LT, "Inpatient cost for hip fracture patients managed with an orthogeriatric care model in Singapore", Singapore Med J, 58, pp.139~144 (2017)
- Yoon BH, "Epidemiology of proximal femoral fractures in South Korea", Arch Osteoporos, 8, pp.157~ (2013)
- Haleem S, "Mortality following hip fracture : trends and geographical variations over the last 40 years", Injury, 39, pp.1157~1163 (2008)
- Tolppanen AM, "Comparison of predictors of hip fracture and mortality after hip fracture in community-dwellers with and without Alzheimer’s disease : exposure-matched cohort study", BMC Geriatr, 16, pp.204~ (2016)
- Carpintero P, "Complications of hip fractures : a review", World J Orthop, 5, pp.402~411 (2014)
- Vidán MT, "Causes and effects of surgical delay in patients with hip fracture : a cohort study", Ann Intern Med, 155, pp.226~233 (2011)
- Uzoigwe CE, "Early and ultra-early surgery in hip fracture patients improves survival", Injury, 44, pp.726~729 (2013)
- Al-Ani AN, "Early operation on patients with a hip fracture improved the ability to return to independent living. A prospective study of 850 patients", J Bone Joint Surg Am, 90, pp.1436~1442 (2008)
- Hapuarachchi KS, "Neck of femur fractures in the over 90s : a select group of patients who require prompt surgical intervention for optimal results", J Orthop Traumatol, 15, pp.13~19 (2014)
- Smektala R, "The effect of timeto-surgery on outcome in elderly patients with proximal femoral fractures", BMC Musculoskelet Disord, 9, pp.171~ (2008)
- Moran CG, "Early mortality after hip fracture: is delay before surgery important?", J Bone Joint Surg Am, 87, pp.483~489 (2005)
- Pincus D, "Association between wait time and 30-day mortality in adults undergoing hip fracture surgery", JAMA, 318, pp.1994~2003 (2017)
- Shiga T, "Is operative delay associated with increased mortality of hip fracture patients? Systematic review, meta-analysis, and meta-regression", Can J Anaesth, 55, pp.146~154 (2008)
- Moja L, "Timing matters in hip fracture surgery: patients operated within 48 hours have better outcomes. A meta-analysis and meta-regression of over 190,000 patients", PLoS One, 7, pp.e46175~ (2012)
- Simunovic N, "Effect of early surgery after hip fracture on mortality and complications : systematic review and meta-analysis", CMAJ, 182, pp.1609~1616 (2010)
- Association of Anaesthetists of Great Britain and Ireland, "Management of proximal femoral fractures 2011: Association of Anaesthetists of Great Britain and Ireland", Anaesthesia, 67, pp.85~98 (2012)
- Orosz GM, "Association of timing of surgery for hip fracture and patient outcomes", JAMA, 291, pp.1738~1743 (2004)
- Khan SK, "Timing of surgery for hip fractures : a systematic review of 52 published studies involving 291, 413 patients", Injury, 40, pp.692~697 (2009)
- Siegmeth AW, "Delay to surgery prolongs hospital stay in patients with fractures of the proximal femur", J Bone Joint Surg Br, 87, pp.1123~1126 (2005)
- Lefaivre KA, "Length of stay, mortality, morbidity and delay to surgery in hip fractures", J Bone Joint Surg Br, 91, pp.922~927 (2009)
- Grimes JP, "The effects of time-to-surgery on mortality and morbidity in patients following hip fracture", Am J Med, 112, pp.702~709 (2002)
- Shin WC, "Preoperative prevalence of and risk factors for venous thromboembolism in patients with a hip fracture : an indirect multidetector CT venography study", J Bone Joint Surg Am, 98, pp.2089~2095 (2016)
- Doruk H, "The effect of the timing of hip fracture surgery on the activity of daily living and mortality in elderly", Arch Gerontol Geriatr, 39, pp.179~185 (2004)
- Elliott J, "Predicting survival after treatment for fracture of the proximal femur and the effect of delays to surgery", J Clin Epidemiol, 56, pp.788~795 (2003)
- Fox HJ, "Factors affecting the outcome after proximal femoral fractures", Injury, 25, pp.297~300 (1994)
- McGuire KJ, "The 2004Marshall Urist award: delays until surgery after hip fracture increases mortality", Clin Orthop Relat Res, (428), pp.294~301 (2004)
- Novack V, "Does delay in surgery after hip fracture lead to worse outcomes? A multicenter survey", Int J Qual Health Care, 19, pp.170~176 (2007)
- Parker MJ, "The timing of surgery for proximal femoral fractures", J Bone Joint Surg Br, 74, pp.203~205 (1992)
- Radcliff TA, "Patient risk factors, operative care, and outcomes among older community-dwelling male veterans with hip fracture", J Bone Joint Surg Am, 90, pp.34~42 (2008)