No association between surgical delay and mortality following distal femoral fractures: A study from the danish fracture database collaborators

TY - JOUR

T1 - No association between surgical delay and mortality following distal femoral fractures

T2 - A study from the danish fracture database collaborators

AU - Nyholm, Anne Marie

AU - Palm, Henrik

AU - Kallemose, Thomas

AU - Troelsen, Anders

AU - Gromov, Kirill

AU - DFDB collaborators

N1 - Copyright © 2017 Elsevier Ltd. All rights reserved.

PY - 2017/12

Y1 - 2017/12

N2 - BACKGROUND: The purpose of this study was to investigate whether surgical delay or the educational level of surgeon is associated with early mortality in patients with distal femoral fractures.METHODS: 392 consecutive patients aged ≥50 years registered in the Danish Fracture Database for surgery of a non-pathological, closed, low-energy distal femoral fracture (AO33A-C) were included. Data included age, gender, American Society of Anaesthesiologists (ASA) score, type of fracture, educational level of surgeon and surgical delay. Educational level of surgeon was defined as "attending or above as surgeon", "attending or above as supervisor" or "below attending alone". Surgical delay was defined as hours (h) from radiological diagnostics until onset of surgery. Mortality data was provided by The Civil Registration System. Mortality rates were calculated using multiple logistical regression analysis.RESULTS: Mean age was 76 years (range 50-101), 79% of patients were female and 65% had an extra articular fracture (AO33A). 8% were operated within 12h, 33% within 24h, 67% within 48h and 83% within 72h. Educational level of surgeon was "attending or above as surgeon" in 56% of all cases and "attending or above as supervisor" in 33%. Mortality was 7.1% at day 30 and 12.5% at day 90. The logistical regression analysis did not demonstrate any association between surgical delay or educational level of surgeon and mortality. Increasing age, male gender and ASA score >2 significantly increased both 30-day and 90-day mortality.CONCLUSION: No association between surgical delay or educational level of surgeon and mortality was found. These findings do not support the development of guidelines for decreasing surgical delay in this population.

AB - BACKGROUND: The purpose of this study was to investigate whether surgical delay or the educational level of surgeon is associated with early mortality in patients with distal femoral fractures.METHODS: 392 consecutive patients aged ≥50 years registered in the Danish Fracture Database for surgery of a non-pathological, closed, low-energy distal femoral fracture (AO33A-C) were included. Data included age, gender, American Society of Anaesthesiologists (ASA) score, type of fracture, educational level of surgeon and surgical delay. Educational level of surgeon was defined as "attending or above as surgeon", "attending or above as supervisor" or "below attending alone". Surgical delay was defined as hours (h) from radiological diagnostics until onset of surgery. Mortality data was provided by The Civil Registration System. Mortality rates were calculated using multiple logistical regression analysis.RESULTS: Mean age was 76 years (range 50-101), 79% of patients were female and 65% had an extra articular fracture (AO33A). 8% were operated within 12h, 33% within 24h, 67% within 48h and 83% within 72h. Educational level of surgeon was "attending or above as surgeon" in 56% of all cases and "attending or above as supervisor" in 33%. Mortality was 7.1% at day 30 and 12.5% at day 90. The logistical regression analysis did not demonstrate any association between surgical delay or educational level of surgeon and mortality. Increasing age, male gender and ASA score >2 significantly increased both 30-day and 90-day mortality.CONCLUSION: No association between surgical delay or educational level of surgeon and mortality was found. These findings do not support the development of guidelines for decreasing surgical delay in this population.

U2 - 10.1016/j.injury.2017.10.022

DO - 10.1016/j.injury.2017.10.022

M3 - Journal article

C2 - 29050688

SN - 0020-1383

VL - 48

SP - 2833

EP - 2837

JO - Injury

JF - Injury

IS - 12

ER -