Is There a 'Weekend Effect' in Intertrochanteric Fracture Surgery?
| Autor: | Zhiyong Hou, Xian Gao, Yingze Zhang, Qiujun Wang, Junfei Guo, Qi Zhang, Pengyu Ye, Zhiqian Wang |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Aging
Hip fracture Univariate analysis medicine.medical_specialty Weekend effect Hip Fractures Proportional hazards model business.industry Mortality rate Medical record Retrospective cohort study Length of Stay medicine.disease Surgery Hospitalization Harris Hip Score medicine Humans Geriatrics and Gerontology business Aged Proportional Hazards Models Retrospective Studies |
| Zdroj: | Gerontology. 68:877-888 |
| ISSN: | 1423-0003 0304-324X |
| Popis: | Introduction: Numerous studies reported poorer outcomes for patients who were admitted at weekends or off-hour, which relates to the underlying concept called the “weekend effect.” We aimed to assess the effect of adverse outcomes in older patients with intertrochanteric fracture surgery. Methods: A retrospective cohort study of patients aged ≥65 years with intertrochanteric fracture surgery. Data were collected from computerized medical records and all patients had a long-term follow-up. The association between weekend effect with adverse outcomes and factors for all-cause mortality was studied by 3-group comparison, Spearman and partial correlation analysis, univariate analysis, and multivariate Cox proportional-hazard model. Results: Our results showed no evidence supporting the existence of a weekend effect on adverse outcomes, including mortality rates (p = 0.950, log-rank), length of hospital stay, total hospital costs, rate and volume of transfusion, visual analog scale score, Harris Hip Score, and specific complications (all p > 0.05), except for an average of 0.5 days longer surgical delay found in patients admitted on Fridays relative to other days (p = 0.013). Instead, only age group (with a 10-year interval, HR 1.43, 1.28–1.59 95% CI, p < 0.001) and surgical delay (HR 1.05, 1.02–1.07 95% CI, p < 0.001) were identified as significantly associated with all-cause mortality. Conclusions: Older patients with intertrochanteric fracture surgery have similar mortality and adverse outcomes rates when admitted on weekends or holidays compared with weekdays. Our findings suggest that collaborative multidisciplinary team care seems both effective and efficient in the management of older patients with intertrochanteric fractures on any day of the week. |
| Databáze: | OpenAIRE |
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