Preoperative Consultations and Their Effect on Surgical Delays and Mortality in Hip Fracture Surgery
ABSTRACT Objective The impact of preoperative consultations on mortality and morbidity rates, and their association with delays and hospital stays for surgery, remains a topic of discussion. This study aims to elucidate the necessity of consultations for those undergoing femoral neck fracture surger...
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| Format: | Article |
| Language: | English |
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Wiley
2025-01-01
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| Series: | Orthopaedic Surgery |
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| Online Access: | https://doi.org/10.1111/os.14283 |
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| author | Ekin Kaya Şimşek Barış Kafa Bahtiyar Haberal |
| author_facet | Ekin Kaya Şimşek Barış Kafa Bahtiyar Haberal |
| author_sort | Ekin Kaya Şimşek |
| collection | DOAJ |
| description | ABSTRACT Objective The impact of preoperative consultations on mortality and morbidity rates, and their association with delays and hospital stays for surgery, remains a topic of discussion. This study aims to elucidate the necessity of consultations for those undergoing femoral neck fracture surgery, examining their influence on delays, hospital durations, and their correlation with mortality rates. Methods The study examined data from 320 emergency department patients with femoral neck fractures undergoing hip arthroplasty surgery at our hospital between 2011 and 2021, using digital medical records. Patients were consulted in relevant departments for risk optimization. They were categorized into two groups based on the time of surgery: Group 1 (operated within 48 h) and Group 2 (delayed surgery). The analysis included days from admission to surgery, total hospital stay, and time from surgery to discharge. Mortality rates, with a minimum 2‐year follow‐up, were assessed using digital records, patient contact, or a death notification system. Statistical analyses involved Mann–Whitney U, Kruskal–Wallis, post hoc analysis, Pearson's chi‐squared, and Fisher–Freeman–Halton tests (α = 0.05). SPSS v25.0 software was used. Results Patients with consultation requests experience significantly delayed surgery compared to those without (p < 0.001). Statistically significant differences were observed between consulted and nonconsulted groups in time until surgery (p < 0.001), time from surgery to discharge (p < 0.001), and overall length of hospital stay (p < 0.001). However, there is no statistically significant difference in 30‐day and 1‐year mortality between consulted and nonconsulted patients, both departmentally and overall. Conclusion This study found that advanced age and high ASA scores were the main factors causing surgical delays in hip fracture patients. While modifiable comorbidities could reduce hospital stays, they did not significantly affect postoperative mortality. Streamlining elective consultations and reducing organizational delays could help prevent delayed surgeries and improve outcomes. |
| format | Article |
| id | doaj-art-c9080b8a0322465495e7e052ce7e1c41 |
| institution | Kabale University |
| issn | 1757-7853 1757-7861 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj-art-c9080b8a0322465495e7e052ce7e1c412025-01-16T05:31:15ZengWileyOrthopaedic Surgery1757-78531757-78612025-01-0117117218010.1111/os.14283Preoperative Consultations and Their Effect on Surgical Delays and Mortality in Hip Fracture SurgeryEkin Kaya Şimşek0Barış Kafa1Bahtiyar Haberal2Department of Orthapaedics and Traumatology, Faculty of Medicine Başkent University Ankara TurkeyDepartment of Orthapaedics and Traumatology Gülhane Training and Research Hospital Ankara TurkeyDepartment of Orthapaedics and Traumatology, Faculty of Medicine Başkent University Ankara TurkeyABSTRACT Objective The impact of preoperative consultations on mortality and morbidity rates, and their association with delays and hospital stays for surgery, remains a topic of discussion. This study aims to elucidate the necessity of consultations for those undergoing femoral neck fracture surgery, examining their influence on delays, hospital durations, and their correlation with mortality rates. Methods The study examined data from 320 emergency department patients with femoral neck fractures undergoing hip arthroplasty surgery at our hospital between 2011 and 2021, using digital medical records. Patients were consulted in relevant departments for risk optimization. They were categorized into two groups based on the time of surgery: Group 1 (operated within 48 h) and Group 2 (delayed surgery). The analysis included days from admission to surgery, total hospital stay, and time from surgery to discharge. Mortality rates, with a minimum 2‐year follow‐up, were assessed using digital records, patient contact, or a death notification system. Statistical analyses involved Mann–Whitney U, Kruskal–Wallis, post hoc analysis, Pearson's chi‐squared, and Fisher–Freeman–Halton tests (α = 0.05). SPSS v25.0 software was used. Results Patients with consultation requests experience significantly delayed surgery compared to those without (p < 0.001). Statistically significant differences were observed between consulted and nonconsulted groups in time until surgery (p < 0.001), time from surgery to discharge (p < 0.001), and overall length of hospital stay (p < 0.001). However, there is no statistically significant difference in 30‐day and 1‐year mortality between consulted and nonconsulted patients, both departmentally and overall. Conclusion This study found that advanced age and high ASA scores were the main factors causing surgical delays in hip fracture patients. While modifiable comorbidities could reduce hospital stays, they did not significantly affect postoperative mortality. Streamlining elective consultations and reducing organizational delays could help prevent delayed surgeries and improve outcomes.https://doi.org/10.1111/os.14283femoral neck fracturesmortalitypreoperative period |
| spellingShingle | Ekin Kaya Şimşek Barış Kafa Bahtiyar Haberal Preoperative Consultations and Their Effect on Surgical Delays and Mortality in Hip Fracture Surgery Orthopaedic Surgery femoral neck fractures mortality preoperative period |
| title | Preoperative Consultations and Their Effect on Surgical Delays and Mortality in Hip Fracture Surgery |
| title_full | Preoperative Consultations and Their Effect on Surgical Delays and Mortality in Hip Fracture Surgery |
| title_fullStr | Preoperative Consultations and Their Effect on Surgical Delays and Mortality in Hip Fracture Surgery |
| title_full_unstemmed | Preoperative Consultations and Their Effect on Surgical Delays and Mortality in Hip Fracture Surgery |
| title_short | Preoperative Consultations and Their Effect on Surgical Delays and Mortality in Hip Fracture Surgery |
| title_sort | preoperative consultations and their effect on surgical delays and mortality in hip fracture surgery |
| topic | femoral neck fractures mortality preoperative period |
| url | https://doi.org/10.1111/os.14283 |
| work_keys_str_mv | AT ekinkayasimsek preoperativeconsultationsandtheireffectonsurgicaldelaysandmortalityinhipfracturesurgery AT barıskafa preoperativeconsultationsandtheireffectonsurgicaldelaysandmortalityinhipfracturesurgery AT bahtiyarhaberal preoperativeconsultationsandtheireffectonsurgicaldelaysandmortalityinhipfracturesurgery |