• Sean M Mitchell, Andrew S Chung, Joseph B Walker, Joshua W Hustedt, George V Russell, and Clifford B Jones.
• Department of Orthopaedic Surgery, The University of Arizona, Phoenix, AZ.
• J Orthop Trauma. 2018 Dec 1; 32 (12): 629-633.

ObjectivesTo evaluate the association between the timing of hip fracture surgery with postoperative length of stay and outcomes.DesignRetrospective review using the American College of Surgeons National Surgical Quality Improvement Program database.SettingNational inquiry database incorporating 140 academic and private medical centers.PatientsSeventeen thousand four hundred fifty-nine patients who underwent surgery for a hip fracture between 2006 and 2013 were identified from the National Surgical Quality Improvement Program database.InterventionSurgical management of hip fractures was performed at the discretion of participating surgeons.Outcome MeasureThirty-day outcomes including postoperative length of stay, readmission rates, reoperation rates, complications, and mortality rates.ResultsOf the 17,459 patients, 4107 (23.5%) were operated on within 24 hours, 8740 (50.1%) within 24-48 hours, and 4612 (26.4%) more than 48 hours after hospital admission. Increased time to surgery was associated with longer postoperative hospital length of stay. Prolonged time to surgery did not adversely affect postoperative outcomes.ConclusionsAlthough a delay in the management of hip fractures is associated with an increase in postoperative hospital length of stay, 30-day postoperative outcomes are not adversely affected in patients undergoing hip fracture fixation.Level Of EvidencePrognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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