| Objective: To investigate the effects of preoperative time on the survival of fragile hip fractures.Admission time,admission to operation time and injury to operation time were concluded as preoperative time.Methods: We retrospectively analyzed hip fracture patients admitted to our hospital from January 2014 to December 2016.Patients' postoperative survival and perioperative complications were followed up.Time of injury,time of hospitalization and operation time were reviewed.Patients were grouped according to three different preoperative time factors.According to the time from hospital admission to injury patients were divided into two groups of <2 days and ?2 days.<4 days and ?4 days were divided according to the in-hospital to operative time.According to the time from injury to surgery patients was divided into two groups of <6 days and ?6 days;Kaplan-Meier survival analysis was used to compare the postoperative survival rate of patients with fragile hip fracture from different injuries to hospitalization time,hospitalization to operation time and injury to operation time.Cox regression analysis was used to calculate the risk ratio of the time factor to the postoperative survival rate by adjust the other risk factors.In the end,we compared the perioperative complications in different groups which were divided by the time of injury to surgery,hospitalization to operation time,and admission time.Results: In 591 patients with fragile hip fractures,the age ranged from 50 to 103 years and the average was 76.56±10.53 years.The ratio of male to female was approximately 1:2,we followed up 107 patients deaths(18.1%).Time from admission to hospital is 1 to 41 days,an average of 3.90±5.367 days.269 cases <2 days,322 cases ? 2 days;Time from hospitalization to surgery is 0 to 34 days,an average of 4.87±2.881 days,200 cases <4 days,391 cases ? 4 days;Time from injury to surgery is 1 to 44 days,an average of 7.78±6.152 days,268 cases <6 days,323 cases ?6 days.Time from injury to hospital admission ?2 days significantly reduced the survival rate after surgery(p<0.001).There was no significant difference in the postoperative survival rate between hospitalization to operation time of ?4 days and <4 days(p=0.102).The postoperative survival rate was significantly decreased in patients who had operation ?6 days after injure(p=0.045).The risk of postoperative death increased by 6.4% for each additional day increase in admission time(HR1.064,95% CI 1.037 to 1.091,p<0.001).The risk of postoperative death increased by 5.5% for each additional day of injury to operative time(HR1.055,95% CI 1.031 to 1.080,P<0.001).The increase in hospitalization to surgery time was not significantly associated with postoperative mortality(p= 0.400).Time from injury to admission ?2 days significantly increased the incidence of perioperative pulmonary infection and pressure sore.Time from hospitalization to surgery ?4 days significantly increased the incidence of perioperative pulmonary infection and heart failure.Time from injury to surgery ?6 days significantly increase the incidence of perioperative pulmonary infections and pressure sore.Conclusion: 1.The incidence of perioperative pulmonary infection and hemorrhoids increased significantly and the postoperative survival rate was significantly reduced in patients with fragile hip fractures who were admitted to hospital ? 2 days from injured.Each time from injury to hospital was increased by 1 day,the risk of patient died after surgery increased by 6.4%.2.The increase of time from hospitalization to operation significantly increased the incidence of perioperative pulmonary infection and heart failure in elderly patients with fragile hip fractures.3.It is very important to get to a hospital with the ability to diagnose and treat the disease as soon as possible after the fragile hip fracture. |
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