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Master Thesis

Impact du délai chirurgical et des motifs de report sur les complications postopératoires chez les patients admis pour fracture de l’extrémité supérieure du fémur : étude prospective monocentrique

Abstract : Introduction: Surgical delay is one of the important points in the management of hip fractures (HF). Whether early surgery for hip fractures is effective remains controversial. We examined the impact of factors that delay surgery in patients with hip fractures treated at our hospital. Material and methods: Over a period of three months, all consecutive patients admitted in the emergency department of CHU Pellegrin between November 2013 and February 2014 for a surgical HF were included. An inappropriate surgical delay was defined by a delay > 48 hours after admission. For each patient, perioperative management and complications during primary hospitalization or within 30 days after surgery were recorded. A telephonic follow-up of patients and / or family member was repeated at 3 and 12 months. The primary outcome was mortality at one year, compared in univariate and multivariate analysis. Results: Among 104 patients treated for hip fracture, 25 patients (24%) received late surgery. Overall, the prevalence of inappropriate surgical delay was 18%. The 1-year mortality was significantly higher in late surgery (21% vs. 45%, p = 0.022). A surgical delay > 48 hours was statistically associated with 1-year mortality with an OR 16.6 [2.7 to 102.5], p = 0.002. The perioperative management during the surgical delay was sub-optimal in terms of analgesia, nutrition, management of preoperative treatment and prevention of cognitive disorders. Conclusion: A surgical delay > 48 hours is associated with higher mortality after hip fracture surgery. A reflection on multidisciplinary protocols in our service, as is already the case in many hospitals, appears to be essential.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01244448
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Tuesday, December 15, 2015 - 5:48:05 PM
Last modification on : Thursday, May 30, 2019 - 5:46:47 PM
Long-term archiving on: : Saturday, April 29, 2017 - 3:34:29 PM

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Pierre Emmanuel Meynieu. Impact du délai chirurgical et des motifs de report sur les complications postopératoires chez les patients admis pour fracture de l’extrémité supérieure du fémur : étude prospective monocentrique. Médecine humaine et pathologie. 2015. ⟨dumas-01244448⟩

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