Fracture :: Delayed hip fracture surgery has worse health outcomes

Almost two-thirds (65%) of hip fracture patients aged 65 and older had surgery on the day they were admitted to hospital or the next day in 2005?2006, but new indicators published by the Canadian Institute for Health Information (CIHI) show that some patients have longer waits.

For example, 8% of seniors admitted to Canadian hospitals outside Quebec with hip fractures (about 1,400 patients) spent four or more days in hospital before undergoing surgery.

CIHI?s annual Health Indicators 2007 report,produced with Statistics Canada, provides over 40 measures of health and health system performance in Canada and now includes indicators on wait time for hip fracture surgery.

?For the first time, we can compare how quickly seniors who break a hip in different parts of the country undergo surgery, from eastern Newfoundland to Vancouver Island,? says Jennifer Zelmer, CIHI?s Vice President of Research and Analysis. ?This is important new information, because evidence suggests that hip fracture patients who have surgery sooner tend to have better health outcomes.?

CIHI?s analysis found that longer waits for surgery were associated with higher short-term death rates. In 2005?2006, in hospitals outside of Quebec, about 17,000 surgical procedures to repair hip fractures on patients aged 65 and older were performed. Overall, about 6% of these, or about 1,000 patients, died in hospital within 30 days of admission. The mortality risk for patients who waited longer for surgery was 22% higher than for those treated on the day of admission to hospital or the next day, after accounting for other factors that affect mortality such as age and other health problems.

?Hip fractures represent a tremendous health burden for seniors. Recovery is often slow and painful, and many patients experience a loss of mobility and other health problems,? says Dr. Michael Dunbar, Associate Professor of Orthopedic Surgery at Dalhousie University.?While there are medical reasons to delay surgery for some patients, research has shown that patients who wait longer for surgery to repair a broken hip are more likely to experience complications, to have longer stays in hospital and to have poorer recovery of function.?

For example, CIHI?s report found that patients who underwent hip fracture surgery on the day they were admitted to hospital or the next day spent an average of 18.5 days in hospital aftersurgery, compared to an average of 20.5 days after surgery for those who waited longer.

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