• Injury · Nov 2023

    Potential predictors for surgical delay in patients with intertrochanteric fractures and their impact on hospitalization length, in a Latin American trauma center.

    • Ricardo José Méndez Medina, Ángela Rocío Hernández Arenas, José Vicente Barrera Orozco, and Daniel Orlando Rodríguez Villanueva.
    • Orthopedic Trauma Surgeon, Clínica Nueva El Lago, Bogotá, Colombia. Electronic address: rmendezm@unbosque.edu.co.
    • Injury. 2023 Nov 1; 54 Suppl 6: 110807110807.

    IntroductionThe incidence of intertrochanteric fractures is increasing, and health institutions must know the profile of their patients. This paper describes the relationship between clinical characteristics and attention process with surgical delay and prolonged hospitalization length in patients with intertrochanteric fractures admitted to a Latin-American trauma center.Materials And MethodsRetrospective, comparative, cross-sectional study. The medical records of patients admitted for intertrochanteric fracture between August 1st 2019 and May 31st 2021 were reviewed to extract data regarding clinical characteristics, causes of surgery delay, and hospitalization length. Regression models were used to distinguish potential predictor variables on surgical delay and hospitalization length.Results362 cases with intertrochanteric fractures were surgically treated during the study period. The mean time from admission to surgery was 4.2 ± 3.8 days. in 33,1% of the cases the surgery was performed within the first 48 h. A history of coronary heart disease (CHD) and chronic kidney disease were potential predictors of surgery delay (p<0.005). Only CHD was independently associated with surgery delay (OR 5.267 [95%CI 1.201-23.100); p = 0.028). Hospitalization was extended in cases where surgery was performed after 48 h (10,1 ± 6,2 days vs 5,9 ± 3,0 days; p<0.001). The regression model showed that for each day passed from fracture to admission and each day from admission to surgery, the hospitalization duration increased by 3,7 and 4,4 days, respectively.DiscussionPatients with intertrochanteric fractures have comorbidities that potentially delay their surgical treatment and prolong hospitalization duration. The efficient use of hospital resources and the proper early evaluation of cardiac pathologies conducted during admission, could positively impact the achievement of surgical treatment within the first 48 h after the fracture, reducing hospitalization duration.Copyright © 2023 Elsevier Ltd. All rights reserved.

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