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There is no weekend effect in hip fracture surgery - A comprehensive analysis of outcomes.

Authors :
Sheikh, Hassaan Q.
Aqil, Adeel
Hossain, Fahad S.
Kapoor, Harish
Source :
Surgeon (Elsevier Science). Oct2018, Vol. 16 Issue 5, p259-264. 6p.
Publication Year :
2018

Abstract

<bold>Background: </bold>Previous studies have shown that some patient groups suffer adverse outcomes if they are acutely admitted to hospital over a weekend. We aimed to investigate this 'weekend effect' at our centre in patients presenting with a hip fracture.<bold>Methods: </bold>Consecutive patients undergoing acute hip fracture surgery were identified from a prospective database. Patient demographics, co-morbidities, fracture type, admission blood parameters were examined. Outcomes analysed included 30-day, 90-day and 1-year mortality as well as length of stay, re-operations and delay to surgery. The data were analysed with regards to day of admission and day of surgery separately.<bold>Results: </bold>A total of 1326 patients were included, of which 368 patients were admitted over a weekend and 411 patients had their operation over a weekend. Overall 30-day mortality was 7.6% (101 patients), whilst the 90-day and 1-year mortalities were 15.3% and 26.8% (203 and 356 patients). There were no significant differences in any of the outcomes based on the day of admission or the day of surgery. Multivariate analysis for 30-day mortality demonstrated the following variables to be significant predictors: admission urea levels (hazard ratio (HR) 1.042, p = 0.027), age (HR 1.058, p < 0.001), admission source (HR 1.428, p < 0.001), surgical delay >48 h (HR 1.853, p = 0.004), male gender (HR 1.967, p = 0.003), previous stroke (HR 2.261, p = 0.038), acute chest infection (4.240, p < 0.001) and chronic liver disease (HR 4.581, p = 0.014).<bold>Conclusion: </bold>This data suggests that there is no significant weekend effect in hip fracture surgery and mortality is affected by patient co-morbidities and delay to surgery. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
1479666X
Volume :
16
Issue :
5
Database :
Academic Search Index
Journal :
Surgeon (Elsevier Science)
Publication Type :
Academic Journal
Accession number :
131768613
Full Text :
https://doi.org/10.1016/j.surge.2017.11.001