Morbidity and mortality following femoral fractures in the elderly – is the 48 hours limit obligatory?

Purpose : To study the influence of a national quality program for early surgical treatment for fragility hip fractures on patients' outcomes. M ethods : A retrospective study comparing consecutive patients, 65 years and older, who were operated for proximal femoral fractures in the two years preceding and succeeding the initiation of the national quality program in 2013. Primary outcome was 1-year survival. Secondary outcomes were surgery within 48 hours, in-hospital complications and mortality, recurrent hospitalizations and orthopedic complications in the post-operative year. Results: 267 patients were treated in 2011-2012, and 328 patients in 2013-2014 were included. Patients' baseline characteristics were comparable. There was an 8% rise in the percentage of patients undergoing surgery within 48 hours. Other outcomes, including 1-year survival did not differ between groups. Conclusion : While the national quality program increased the percentage of patients treated within 48 hours, this was not found to correlate with a beneficial effect, either in the immediate or delayed period.