A Retrospective Study in Elderly Patients with Hip Fractures at Bangplee Hospital: Delayed Surgery is Associated with Increased Morbidity, Mortality, and Length of Stay

Abstract

Hip fracture in elderly is a common orthopedic emergency. Delayed surgery may increase the risk of complications, mortality, and length of stay. This study aims to compare clinical outcomes between patients who underwent surgery within 72 hours and those who underwent surgery after 72 hours at Bangplee Hospital. A retrospective analytical study was conducted in patients aged ≥ 65 years who underwent hip fracture surgery at Bangplee Hospital between 2023 and 2024. A total of 36 patients were included and divided into two groups: an early surgery group (within 72 hours; n = 18) and a delayed surgery group (> 72 hours; n = 18). Data were collected from medical records, including baseline characteristics, postoperative complications, in-hospital mortality, and length of stay. Descriptive statistics were used, while group comparisons were performed using the t-test for continuous variables and Fisher’s exact test for categorical variables.

The results showed that the delayed surgery group had significantly higher rates of urinary tract infection (66.7% vs. 16.7%, p = 0.006), pressure ulcers (77.7% vs. 16.7%, p < 0.001), and acute delirium (61.1% vs. 11.1%, p = 0.005) compared with the early surgery group. In addition, the delayed surgery group had a significantly longer mean hospital stay (18.4 ± 6.3 days vs. 10.2 ± 5.5 days, p < 0.001). No in-hospital mortality was observed in this study.

In conclusion, delayed hip fracture surgery beyond 72 hours in elderly is associated with increased postoperative complications-particularly urinary tract infection, pressure ulcers, and acute delirium-as well as prolonged length of stay. Enhancing systems to reduce surgical waiting times is therefore crucial for improving the quality of care for this patient population.