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Impact of timing of surgery in elderly hip fracture patients: a systematic review and meta-analysis

Klestil, Thomas ; Röder, Christoph ; Stotter, Christoph ; Winkler, Birgit ; Nehrer, Stefan ; Lutz, Martin ; Klerings, Irma ; Wagner, Gernot ; Gartlehner, Gerald ; Nussbaumer-Streit, Barbara

Scientific reports, 2018-09, Vol.8 (1), p.13933-15, Article 13933 [Periódico revisado por pares]

England: Nature Publishing Group

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Título:
Impact of timing of surgery in elderly hip fracture patients: a systematic review and meta-analysis
Autor: Klestil, Thomas ; Röder, Christoph ; Stotter, Christoph ; Winkler, Birgit ; Nehrer, Stefan ; Lutz, Martin ; Klerings, Irma ; Wagner, Gernot ; Gartlehner, Gerald ; Nussbaumer-Streit, Barbara
Assuntos: Aged ; Clinical trials ; Fractures ; Geriatrics ; Health risk assessment ; Hip ; Hip Fractures - surgery ; Humans ; Meta-analysis ; Morbidity ; Mortality ; Observational Studies as Topic ; Odds Ratio ; Postoperative Complications - prevention & control ; Pressure Ulcer - surgery ; Prospective Studies ; Randomized Controlled Trials as Topic ; Risk ; Statistical analysis ; Studies ; Surgery ; Systematic review ; Time Factors ; Ulcers
É parte de: Scientific reports, 2018-09, Vol.8 (1), p.13933-15, Article 13933
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Descrição: We aimed to assess the impact of timing of surgery in elderly patients with acute hip fracture on morbidity and mortality. We systematically searched MEDLINE, the Cochrane Library, Embase, PubMed, and trial registries from 01/1997 to 05/2017, as well as reference lists of relevant reviews, archives of orthopaedic conferences, and contacted experts. Eligible studies had to be randomised controlled trials (RCTs) or prospective cohort studies, including patients 60 years or older with acute hip fracture. Two authors independently assessed study eligibility, abstracted data, and critically appraised study quality. We conducted meta-analyses using the generic inverse variance model. We included 28 prospective observational studies reporting data of 31,242 patients. Patients operated on within 48 hours had a 20% lower risk of dying within 12 months (risk ratio (RR) 0.80, 95% confidence interval (CI) 0.66-0.97). No statistical significant different mortality risk was observed when comparing patients operated on within or after 24 hours (RR 0.82, 95% CI 0.67-1.01). Adjusted data demonstrated fewer complications (8% vs. 17%) in patients who had early surgery, and increasing risk for pressure ulcers with increased time of delay in another study. Early hip surgery within 48 hours was associated with lower mortality risk and fewer perioperative complications.
Editor: England: Nature Publishing Group
Idioma: Inglês

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Impact of timing of surgery in elderly hip fracture patients: a systematic review and meta-analysis

Klestil, Thomas ; Röder, Christoph ; Stotter, Christoph ; Winkler, Birgit ; Nehrer, Stefan ; Lutz, Martin ; Klerings, Irma ; Wagner, Gernot ; Gartlehner, Gerald ; Nussbaumer-Streit, Barbara

England: Nature Publishing Group

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