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Reduced time to surgery improves mortality and length of stay following hip fracture: results from an intervention study in a Canadian health authority.

Can J Surg

August 2015

From the Centre For Healthcare Innovation, University of Manitoba and Winnipeg Regional Health Authority (Bohm, Wittmeier, Lix); the Concordia Hip and Knee Institute, Winnipeg Regional Health RESEARCH Can J Surg, Vol. 58, No. 4, August 2015 263 Authority (Bohm, Loucks); the Department of Surgery, University of Manitoba and Winnipeg Regional Health Authority (Bohm, Oppenheimer); the Department of Pediatrics and Child Health, University of Manitoba (Wittmeier); and the Department of Community Health Sciences, University of Manitoba (Bohm, Lix), Winnipeg, Man.

Background: Existing literature demonstrating the negative impact of delayed hip fracture surgery on mortality consists largely of observational studies prone to selection bias and may overestimate the negative effects of delay. We conducted an intervention study to assess initiatives aimed at meeting a 48-hour benchmark for hip fracture surgery to determine if the intervention achieved a reduction in time to surgery, and if a general reduction in time to surgery improved mortality and length of stay.

Methods: We compared time to surgery, length of stay and mortality between pre- and postintervention patients with a hip fracture using the Kaplan-Meier estimator and Cox proportional hazards model adjusting for age, sex, comorbidities, type of surgery and year.

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