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Timing Matters in Hip Fracture Surgery: Patients Operated within 48 Hours Have Better Outcomes. A Meta-Analysis and Meta-Regression of over 190,000 Patients

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  • Lorenzo Moja
  • Alessandra Piatti
  • Valentina Pecoraro
  • Cristian Ricci
  • Gianni Virgili
  • Georgia Salanti
  • Luca Germagnoli
  • Alessandro Liberati
  • Giuseppe Banfi

Abstract

Background: To assess the relationship between surgical delay and mortality in elderly patients with hip fracture. Systematic review and meta-analysis of retrospective and prospective studies published from 1948 to 2011. Medline (from 1948), Embase (from 1974) and CINAHL (from 1982), and the Cochrane Library. Odds ratios (OR) and 95% confidence intervals for each study were extracted and pooled with a random effects model. Heterogeneity, publication bias, Bayesian analysis, and meta-regression analyses were done. Criteria for inclusion were retro- and prospective elderly population studies, patients with operated hip fractures, indication of timing of surgery and survival status. Methodology/Principal Findings: There were 35 independent studies, with 191,873 participants and 34,448 deaths. The majority considered a cut-off between 24 and 48 hours. Early hip surgery was associated with a lower risk of death (pooled odds ratio (OR) 0.74, 95% confidence interval (CI) 0.67 to 0.81; P

Suggested Citation

  • Lorenzo Moja & Alessandra Piatti & Valentina Pecoraro & Cristian Ricci & Gianni Virgili & Georgia Salanti & Luca Germagnoli & Alessandro Liberati & Giuseppe Banfi, 2012. "Timing Matters in Hip Fracture Surgery: Patients Operated within 48 Hours Have Better Outcomes. A Meta-Analysis and Meta-Regression of over 190,000 Patients," PLOS ONE, Public Library of Science, vol. 7(10), pages 1-13, October.
    • Handle: RePEc:plo:pone00:0046175
    DOI: 10.1371/journal.pone.0046175
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    Cited by:

    1. Kuangguo Zhou & Danmei Xu & Yang Cao & Jue Wang & Yunfan Yang & Mei Huang, 2014. "C-MYC Aberrations as Prognostic Factors in Diffuse Large B-cell Lymphoma: A Meta-Analysis of Epidemiological Studies," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-9, April.
    2. Gutacker, Nils & Siciliani, Luigi & Moscelli, Giuseppe & Gravelle, Hugh, 2016. "Choice of hospital: Which type of quality matters?," Journal of Health Economics, Elsevier, vol. 50(C), pages 230-246.
    3. Andrea Ciaccio, 2023. "The Impact of a Cost-containment Measure on the Quality of Regional Health Services in Italy: a Parametric and a Non-parametric Approach," Working Papers 2023: 24, Department of Economics, University of Venice "Ca' Foscari".
    4. Tarazona Santabalbina FJ & Belenguer Varea A & Avellana Zaragoza JA & Cuesta Peredó D & De la Camara JM & Sivera S, 2018. "Importance of Surgical Delay on Mortality in Patients with Hip Fracture - Mini-Review," Biomedical Journal of Scientific & Technical Research, Biomedical Research Network+, LLC, vol. 3(4), pages 3502-3505, April.
    5. Simona Cohen-Kadosh & Zilla Sinuany-Stern, 2020. "Hip fracture surgery efficiency in Israeli hospitals via a network data envelopment analysis," Central European Journal of Operations Research, Springer;Slovak Society for Operations Research;Hungarian Operational Research Society;Czech Society for Operations Research;Österr. Gesellschaft für Operations Research (ÖGOR);Slovenian Society Informatika - Section for Operational Research;Croatian Operational Research Society, vol. 28(1), pages 251-277, March.
    6. Alberto Grassi & Luca Andriolo & Davide Golinelli & Dario Tedesco & Simona Rosa & Pasquale Gramegna & Jacopo Ciaffi & Riccardo Meliconi & Maria Paola Landini & Giuseppe Filardo & Maria Pia Fantini & S, 2021. "Higher 90-Day Mortality after Surgery for Hip Fractures in Patients with COVID-19: A Case–Control Study from a Single Center in Italy," IJERPH, MDPI, vol. 18(10), pages 1-13, May.
    7. Federico Pennestrì & Sabrina Corbetta & Vittoria Favero & Giuseppe Banfi, 2019. "Fragility Fracture Prevention—Implementing a Fracture Liaison Service in a High Volume Orthopedic Hospital," IJERPH, MDPI, vol. 16(24), pages 1-11, December.

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