@article {Elkbulie000212, author = {Adel Elkbuli and Alyssa Eily and Valerie Polcz and Dessy Boneva and Paul J Spano II and Mark McKenney and Shaikh Hai}, title = {Isolated hip fracture in the elderly and time to surgery: is there an outcome difference?}, volume = {3}, number = {1}, elocation-id = {e000212}, year = {2018}, doi = {10.1136/tsaco-2018-000212}, publisher = {BMJ Specialist Journals}, abstract = {Background Early operative intervention for hip fractures in the elderly is advised to reduce mortality and morbidity. Postoperative complications impose a significant burden on patient outcomes and cost of medical care. Our aim was to determine the relationship between time to surgery and postoperative complications/mortality in patients with hip fracture.Methods This is a retrospective review of data collected from our institution{\textquoteright}s trauma registry for patients >=65 years old with isolated hip fracture and subsequent surgery from 2015 to 2017. Patients were stratified into two groups based on time to surgery after admission: group 1: \<48 hours versus group 2: \>48 hours. Demographic variables included age, gender, race, and Injury Severity Score (ISS). The outcome variables included intensive care unit length of stay (ICU-LOS), deep venous thrombosis (DVT), pulmonary embolism (PE) rate, mortality, and 30-day readmission rates. Analysis of variance was used for analysis, with significance defined as a p value \<0.05.Results A total of 485 patients with isolated hip fracture required surgical intervention. Of those, 460 had surgery \<48 hours and 25 had surgery \>48 hours postadmission. The average ISS was the same in both groups. The average ICU-LOS was significantly higher in the \>48 hours group compared with the \<48 hours group (4.0 vs. 2.0, p\<0.0002). There was no statistically significant difference between groups when comparing DVTand PE rate, 30-day readmission, or mortality rates.Discussion Time to surgery may affect overall ICU-LOS in patients with hip fracture requiring surgical intervention. Time to surgery does not affect complication rates, 30-day readmission, or mortality. Future research should investigate long-term outcomes such as functional status and disability-adjusted life years.Level of evidence III. Retrospective/ prognostic cohort study}, URL = {https://tsaco.bmj.com/content/3/1/e000212}, eprint = {https://tsaco.bmj.com/content/3/1/e000212.full.pdf}, journal = {Trauma Surgery \& Acute Care Open} }