Reasons for Surgical Delay in Hip Fracture Patients
2Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, Israel
Background:
This retrospective review was undertaken to determine what patient or organization factors may be associated with a delay of surgery for hip fracture repair beyond 48 hours.
Methods:
A retrospective cohort study of older patients with hip fracture who underwent surgery during 2019-2020 in a hospital located in northern-central Israel. Characteristics of patients with early surgery (≤ 48 hours from admission, n = 241) and patients with delayed surgery (≥ 48 hours from admission, n = 40) were compared.
Results:
Most of the reasons for the surgical delay were medical, with antiplatelet therapy being the most common (n = 8, 20%). Patients with a cardiac disease (OR = 1.38), pulmonary disease (OR = 1.21), or obesity (OR = 1.18), were more likely to have a delay. Patients with 4+ comorbidities were 2.86 times more likely to have a delay. Unavailable operating rooms were another common reason for the delay (n = 8, 20%). In addition, a higher percentage of patients with delayed surgery were admitted in August and September, in comparison to patients with early surgery, but no difference was found in the day or time of admission.
Conclusion:
Delays in hip fracture surgery in older patients in Israel seem to occur mostly due to medical reasons, although there are clearly organizational reasons as well. Less evident organizational factors may also be present and should be addressed in order to further reduce the delay rate.