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10.3390/jcm10163538
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Article

A Case-Control Study of Hip Fracture Surgery Timing and Mortality at an Academic Hospital: Day Surgery May Be Safer than Night Surgery

by
Alim F. Ramji
,
Maxwell T. Trudeau
*,
Michael R. Mancini
,
Matthew R. LeVasseur
,
Adam D. Lindsay
and
Augustus D. Mazzocca
Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, CT 06030, USA
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2021, 10(16), 3538; https://doi.org/10.3390/jcm10163538
Submission received: 19 July 2021 / Revised: 5 August 2021 / Accepted: 10 August 2021 / Published: 12 August 2021
(This article belongs to the Special Issue Severely Injured Patient in Older Age)
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Abstract

Time from hospital admission to operative intervention has been consistently demonstrated to have a significant impact on mortality. Nonetheless, the relationship between operative start time (day versus night) and associated mortality has not been thoroughly investigated. Methods: All patients who underwent hip fracture surgery at a single academic institution were retrospectively analyzed. Operative start times were dichotomized: (1) day operation—7 a.m. to 4 p.m.; (2) night operation—4 p.m. to 7 a.m. Outcomes between the two groups were evaluated. Results: Overall, 170 patients were included in this study. The average admission to operating room (OR) time was 26.0 ± 18.0 h, and 71.2% of cases were performed as a day operation. The overall 90-day mortality rate was 7.1% and was significantly higher for night operations (18.4% vs. 2.5%; p = 0.001). Following multivariable logistic regression analysis, only night operations were independently associated with 90-day mortality (aOR 8.91, 95% confidence interval 2.19–33.22; p = 0.002). Moreover, these patients were significantly more likely to return to the hospital within 50 days (34.7% vs. 19.0%; p = 0.029) and experience mortality prior to discharge (8.2% vs. 0.8%; p = 0.025). Notably, admission to OR time was not associated with in-hospital mortality (29.22 vs. 25.90 h; p = 0.685). Hip fracture surgery during daytime operative hours may minimize mortalities.
Keywords: hip fracture; surgery; operative start time; day; night; mortality; case-control study hip fracture; surgery; operative start time; day; night; mortality; case-control study

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MDPI and ACS Style

Ramji, A.F.; Trudeau, M.T.; Mancini, M.R.; LeVasseur, M.R.; Lindsay, A.D.; Mazzocca, A.D. A Case-Control Study of Hip Fracture Surgery Timing and Mortality at an Academic Hospital: Day Surgery May Be Safer than Night Surgery. J. Clin. Med. 2021, 10, 3538. https://doi.org/10.3390/jcm10163538

AMA Style

Ramji AF, Trudeau MT, Mancini MR, LeVasseur MR, Lindsay AD, Mazzocca AD. A Case-Control Study of Hip Fracture Surgery Timing and Mortality at an Academic Hospital: Day Surgery May Be Safer than Night Surgery. Journal of Clinical Medicine. 2021; 10(16):3538. https://doi.org/10.3390/jcm10163538

Chicago/Turabian Style

Ramji, Alim F., Maxwell T. Trudeau, Michael R. Mancini, Matthew R. LeVasseur, Adam D. Lindsay, and Augustus D. Mazzocca. 2021. "A Case-Control Study of Hip Fracture Surgery Timing and Mortality at an Academic Hospital: Day Surgery May Be Safer than Night Surgery" Journal of Clinical Medicine 10, no. 16: 3538. https://doi.org/10.3390/jcm10163538

APA Style

Ramji, A. F., Trudeau, M. T., Mancini, M. R., LeVasseur, M. R., Lindsay, A. D., & Mazzocca, A. D. (2021). A Case-Control Study of Hip Fracture Surgery Timing and Mortality at an Academic Hospital: Day Surgery May Be Safer than Night Surgery. Journal of Clinical Medicine, 10(16), 3538. https://doi.org/10.3390/jcm10163538

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