The Sun Should Not Set Twice Before Hip Fracture Repair

A study published in the Canadian Medical Association Journal determined the best time for reducing mortality after hip surgery in medically stable older adults is on the day of admission or the following day, reports Medical Xpress . Canadian Health Ministers have established 48 hours from admission as a standard for 90 percent of hip fracture operations, but the appropriate timing of hip fracture surgery is a matter of debate, with some research suggesting an optimal window of 24 hours. The researchers analyzed data from the Canadian Institute for Health Information on about 140,000 individuals aged 65 or older who had surgery for a first-time hip fracture at 144 hospitals in Canada. They inquired as to how postoperative mortality would change if the same cohort were to undergo surgery on the day of admission, on inpatient day 2, day 3, or after day 3. The team forecast 11 additional deaths for every 1,000 hip fracture surgeries if all surgeries in medically stable persons were performed after inpatient day 3 instead of on admission day. "We suggest that clinicians, administrators, and policy-makers 'not let the sun set twice' on medically stable older adults before their hip fracture repair," says orthopaedic surgeon Pierre Guy. "We estimate that 16.5 percent of in-hospital deaths currently occurring in individuals delayed for more than two days are avoidable by adopting the 'don't let the sun set twice' policy for hip fracture persons."