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· DOS Abstracts
Surgical delay and early mortality in patients with
distal femoral fractures
Bozo Jian, Thomas Kallemose, Henrik Palm, Michael Brix, Anders Troelsen,
Kirill Gromov
Department of Orthopaedic Surgery, Copenhagen University Hospital
Hvidovre
Background:
While fast surgical treatment of proximal femoral fractures is
supported by previous studies and is encouraged by national clinical guideline in
several countries, no consensus exists on optimal timing for surgical treatment
of the equally frail patient group with distal femoral fractures.
Purpose / Aim of Study:
The purpose of this study was to investigate whether
increased surgical delay (SD) in patients with distal femoral fractures is associ-
ated with risk for early mortality.
Materials and Methods:
189 patients surgically treated for distal femoral
fractures in 2008-2013 were identified at two university hospitals. Only pa-
tients > 50 years old were included for analysis (n=170). Recorded parameters
included age, gender, American Society of Anesthesiologists (ASA) score, AO
diagnosis, osteosynthesis type, presence of total knee arthroplasty (TKA) and
SD (hours). SD was defined as time from admission to the hospital to beginning
of surgery and divided into groups: <12h, <24h, <48h, <96h and >96h. 30 and
90 day mortality was recorded. Multiple logistical regression analysis was per-
formed to calculate adjusted risk for 30-day and 90-day mortality.
Findings / Results:
Median age was 78, range (51-99). 80% were female,
96% were treated with plate fixation and 21% had a TKA at the fracture site.
7% were operated within 12 hours, 37% within 24 hours, 62% within 48 hours
and 86% within 96 hours. 30- and 90-day mortality rate was 5% and 11%, re-
spectively. Patients with surgical delay > 24 hours had a significantly increased
90- day mortality risk (OR 5.76; p=0.03)
Conclusions:
Delay of surgery > 24 hours for patients with distal femoral frac-
tures is associated with increased risk for early mortality. This should be taken
into consideration when planning surgery for this group of patients.
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