Authors' objectives:

This study aims to assess the effects of pre-operative delay after femoral fracture in elderly people who are otherwise fit for surgery.

Authors' recommendations: Studies may be compromised by some unadjusted confounding. However, results consistently suggested that earlier operation improved clinical outcomes in people with femoral fracture. Loss to follow up was suspiciously low, suggesting that studies may not have recruited inception cohorts, leading to selection bias that may limit the validity of results. However, conclusions would only be overturned if adverse outcomes were more common in untraced participants who underwent early surgery compared with those who had later surgery. This possibility seems unlikely in view of results in people who were traced. Most of the studies have been conducted overseas, where more senior surgeons and anaesthetists may perform emergency lists. Results may not be applicable if treatment for traumatic fracture is administered by more junior staff, who may be involved more frequently if a policy of reducing delay is implemented. Importantly, we found no evidence of harm from early surgery. Making organisational changes to expedite surgery on the day of admission seems likely to benefit patients and unlikely to harm them.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.wihrd.soton.ac.uk

Year Published: 2002

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: Wessex Institute for Health Research and Development

Contact Address: Pauline King. Wessex Institute for Health Research and Development, Boldrewood Medical School, Bassett Crescent East, Highfield, Southampton. SO16 7PX Tel. +44 1703 595661 Fax +44 1703 595662

Copyright: Bazian Ltd, Wessex Institute for Health Research and Development