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Inicio Revista Española de Cirugía Ortopédica y Traumatología (English Edition) Analysis of surgical delay and its influence on morbimortality in patients with ...
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Vol. 63. Issue 3.
Pages 246-251 (May - June 2019)
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Vol. 63. Issue 3.
Pages 246-251 (May - June 2019)
Review article
DOI: 10.1016/j.recote.2018.07.014
Analysis of surgical delay and its influence on morbimortality in patients with hip fracture
Análisis de las causas de demora quirúrgica y su influencia en la morbimortalidad de los pacientes con fractura de cadera
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S. Correoso Castellanos
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silviacorreoso22.scc@gmail.com

Corresponding author.
, F. Lajara Marco, M.M. Díez Galán, E. Blay Dominguez, P.F. Bernáldez Silvetti, M.A. Palazón Banegas, J.A. Lozano Requena
Hospital Vega Baja, Orihuela, Alicante, Spain
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Tables (4)
Table 1. Description of the characteristics of the 5 groups according to the cause of the delay to surgery.
Table 2. Surgical wound complications, general complications and mortality asked with surgical delay.
Table 3. Description of general complications.
Table 4. Description of the surgical wound complications.
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Abstract
Introduction

Surgical delay for hip fractures (>48h) has been associated with greater adverse clinical events. However, the influence of the reasons for delay is unclear. The objective of this study was to analyse the causes of surgical delay and its influence on morbidity and mortality, in patients with hip fracture with indication for surgical treatment.

Material and method

A cohort of 376 hip fractures operated at our centre between January 2012 and December 2016 was retrospectively reviewed. Patients younger than 65 years and pathological fractures were excluded. Of these, 280 patients were operated with a surgical delay >48h. The causes of the delay were: antiaggregation (AG), anticoagulation (AC), medical reasons (MM), preoperative cardiac tests or administrative/organisational reasons. Surgical wound complications, general complications and mortality were compared.

Results

There was a greater proportion of surgical wound complications in the AC group (p=.063). Patients in the AG, AC, and MM groups had higher rates of general associated complications (p=.3). Seven point fifty-one percent of the patients included died one year after surgery. The mortality rate at one year was highest in the MM group (p=.005).

Conclusion

The mortality rate was statistically significantly higher in the MM group. When comparing results, patients in the AG, AC, and MM groups presented higher rates of general complications.

Keywords:
Hip fractures
Reasons for delay
Hip fracture morbidity mortality
Resumen
Introducción

El tratamiento quirúrgico demorado en fracturas de cadera (>48h) se ha asociado con una mayor frecuencia de eventos clínicos adversos. Sin embargo, no está clara la influencia de los motivos de demora en estos resultados. El objetivo de este estudio es el análisis de las causas de demora quirúrgica y su influencia en la morbimortalidad en pacientes con fractura de cadera con indicación de tratamiento quirúrgico.

Material y método

Se revisó retrospectivamente una cohorte de 376 fracturas de cadera intervenidas en nuestro centro entre enero de 2012 y diciembre de 2016. Se excluyó a pacientes menores de 65 años y fracturas patológicas. De ellos, 280 pacientes fueron intervenidos con una demora quirúrgica de >48h. Las causas de la demora fueron: antiagregación (AG), anticoagulación (AC), motivos médicos (MM), test cardíacos preoperatorios o motivos administrativos/organizativos. Se compararon las complicaciones de la herida quirúrgica, las complicaciones generales y la mortalidad.

Resultados

Hubo una mayor proporción de complicaciones de la herida quirúrgica en los AC (p=0,063). Los pacientes de los grupos AG, AC y MM se asociaron a mayores tasas de complicaciones generales (p=0,3). El 7,51% de los pacientes incluidos falleció al año de la cirugía. La tasa de mortalidad al año fue mayor en el grupo MM (p=0,005).

Conclusión

La tasa de mortalidad fue mayor de forma estadísticamente significativa en el grupo MM. Al comparar resultados, los pacientes de los grupos AG, AC y MM presentaron mayores tasas de complicaciones generales.

Palabras clave:
Fracturas de cadera
Causas de demora
Morbimortalidad en fractura de cadera

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