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Abstract
Introduction: Neck of femur fracture is a frequent orthopedic condition treated surgically, with global incidence projected to reach 6.26 million cases annually by 2050. Delays in operative management can influence outcomes, yet the specific factors contributing to such delays require clarification.
Objectives: To identify key factors causing surgical delay beyond 36 hours in neck of femur fractures and evaluate their impact on hospital stay and mortality.
Materials and Methods: A retrospective case–control review of 300 patient records was conducted at a General Hospital in Dudley, West Midlands, UK. Adults undergoing surgical treatment for intracapsular or extracapsular hip fractures were included. Patients operated within 36 hours formed the control group; those with surgery delayed beyond 36 hours formed the case group. Associations between time to surgery (TTS) and clinical outcomes were analyzed using chi-square tests, with p < 0.05 considered significant. Hospital permission was obtained; no IRB approval or data collection tools were required.
Results: A significant association was found between TTS and length of hospital stay (p = 0.036), with delayed surgery linked to hospitalization exceeding two weeks. No significant relationship was observed between TTS and mortality (p = 0.924). Among potential causes of delay, only gender showed a significant association with prolonged TTS (p = 0.001).
Conclusion: Surgery delayed beyond 36 hours increases hospital stay but does not significantly affect mortality. While timely intervention remains important, individualized pre-operative assessments—such as cardiovascular evaluation and hemoglobin optimization—may be prioritized without adversely impacting survival.
Keywords: Hip fracture; Neck of femur; Time to surgery; Mortality; Hospital stay