Role of functional impairment and surgical delay in elderly patients undergoing hip fracture surgery

What is it about?

Delaying hip fracture surgery of more than 2 days is thought to be a long-term risk factor for mortality in elderly patients. Similarly, several studies showed a role for pre-existing disability in activities of daily living (ADL) in affecting the mortality risk. This article describes a population of 390 elderly patients admitted to an Italian Orthogeriatric Unit (Monza, Italy) with hip fracture, and investigates the combined role of surgical delay (more than 2 days) and ADL impairment in affecting mortality over a follow-up period of 12 months.

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Why is it important?

Delaying hip fracture surgery of more than 2 days has a different impact on elderly patients according to their functional status. In particular, subjects with pre-fracture disability in ADL who experience a delay in surgery had a nearly six-fold increased risk of 12-month mortality than patients with neither ADL disability nor delayed surgery. ADL impairment, more than surgical delay, plays a pivotal role in affecting the risk of mortality in the elderly.