The effect of surgical delay after hip fracture on mortality : a retrospective survival analysis of 27,397 surgeries in Argentina
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Thesis degree name:
Maestría en Econometría
Objective: To study the effect of surgical delay after hip fracture on mortality rate in Argentina. Methods: We retrieved data of 27,397 patients (79.6% women, age >= 60) undergoing surgery after hip fracture from Jan 1, 2011 to Dec 31, 2015 and fol- lowed up until Dec 31, 2016. The effect of surgi- cal delay on mortality rates after 1, 2, 3, 6 and 12 months as well as the overall in-sample mortality rate was assessed with a multivariate Cox regression, controlling for age, gender, region, hospital characteristics and 24 comorbidities at baseline. Results: Mean surgical delay was 5.95 days and mean follow-up was 764 days. One-year mortality was 15.4% when delay < 3 days and 19.9% for delay >= 3 days. Surgical delay, age and male sex were found to significantly increase death risk after one year from admission to hospital—Hazard ratio (HR): 1.025 per additional day of delay (standard error = 0.002), p- value<0.001; HR: 1.056 per additional year (0.002), p<0.001; HR: 1.526 (0.043), p<0.001; respectively. Conclusion: Delay from hospital admission to surgery after hip fracture increases mortality in both the short and long run.