ผลของ Waiting time ในผู้ป่วยกระดูกสะโพกหักจากภยันตรายชนิดไม่รุนแรง  ในโรงพยาบาลอุตรดิตถ์

Kangwan Phongdara; Watinee Nakbua; Unchun Pama

doi:10.1016/hscr.v38i1.261469

Authors

Kangwan Phongdara Department of Orthopaedic Surgery, Uttaradit Hospital
Watinee Nakbua Department of Orthopaedic Surgery, Uttaradit Hospital
Unchun Pama Department of Orthopaedic Surgery, Uttaradit Hospital

DOI:

https://doi.org/10.1016/hscr.v38i1.261469

Keywords:

Hip fracture, Fragility fracture, Waiting time, one-year mortality

Abstract

ABSTRACT
Objective: To compare one-year mortality, length of stay in hospital after surgery, and postoperative complications among fragility hip fracture patients who underwent surgery within three days, equal or between four - seven days, and more than or equal eight days.
Study Design: The prognostic factor research (retrospective cohort) analytic study was undertaken
through this study. the patients 50 years of age or older who sustained fragility hip fracture and underwent surgery in the Department of Orthopedic Surgery, Uttaradit Hospital were recruited between 1st of October 2017 and 30th September 2020.
Methods: Review medical records, collect patient information, types of fracture, types of surgery, length of stay in hospital after surgery, postoperative complications among staying in hospital and mortality rate within 30 days, 180 days, and one-years after surgery were reviewed. Data Analysis was used exact probability, risk difference regression, and hazard analysis.
Results: Overall, 446 patients in hip fracture were classified into three groups for patients who underwent surgery; 247 patients within three days, 114 patients between four - seven days and 85 patients greater than or equal to eight days. After adjusting the statistical influence of gender, age, medical condition, ASA classification, duration of surgery and the mobility on discharged from the hospital. The result shown patients who had surgery within three days increased patient discharge by 1.37 times Hazard ratio (HR) 1.37; 95% confidence interval (CI): 1.09-1.79; p=0.022. reduced the mortality rate within one-year to 49% Hazard ratio (HR) 0.49; 95% confidence interval (CI): 0.29-0.82; p=0.007 and reduce the incidence of pneumonia by 5% Risk difference (RD) -0.05; 95% confidence interval (CI): -10.6 to-0.01; p=0.041 compared to patients who had surgery more than or equal to eight days was statistically significant.
Conclusions: Patients with hip fracture from fragility fracture should have surgery within three days due to reducing the incidence of complications during hospitalization, reduce the length of hospital stay
after surgery, and reduced a mortality rate within one-years.
Keywords: Hip fracture, Fragility fracture, Waiting time, one-year mortality

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