Academic Journal
Waiting time and mortality after hip fracture: findings from a large single-center cohort study.
| Title: | Waiting time and mortality after hip fracture: findings from a large single-center cohort study. |
|---|---|
| Authors: | Sundet M; Department of Orthopedic Surgery, Diakonhjemmet Hospital, Box 23, Vinderen, Oslo, N-0319, Norway. mads.sundet@icloud.com.; Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway. mads.sundet@icloud.com., Martinsen M; Department of Orthopedic Surgery, Diakonhjemmet Hospital, Box 23, Vinderen, Oslo, N-0319, Norway., Sexton J; Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway., Sundin U; Department of Orthopedic Surgery, Diakonhjemmet Hospital, Box 23, Vinderen, Oslo, N-0319, Norway.; Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway.; Faculty of Medicine, University of Oslo, Oslo, Norway., Lillegraven S; Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway. |
| Source: | European journal of trauma and emergency surgery : official publication of the European Trauma Society [Eur J Trauma Emerg Surg] 2026 Sep 23; Vol. 52 (1). Date of Electronic Publication: 2026 Sep 23. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Springer Heidelberg Country of Publication: Germany NLM ID: 101313350 Publication Model: Electronic Cited Medium: Internet ISSN: 1863-9941 (Electronic) Linking ISSN: 18639933 NLM ISO Abbreviation: Eur J Trauma Emerg Surg Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2011- : Heidelberg : Springer Heidelberg Original Publication: Munich : Urban & Vogel, 2007- |
| MeSH Terms: | Hip Fractures*/mortality , Hip Fractures*/surgery , Time-to-Treatment*/statistics & numerical data , Waiting Lists*/mortality, Norway/epidemiology ; Humans ; Male ; Female ; Aged, 80 and over ; Aged ; Time Factors ; Treatment Delay ; Cohort Studies ; Proximal Femoral Fractures |
| Abstract: | Purpose: Time to surgery after hip fracture is a potentially modifiable factor that may influence mortality, but the evidence for an association is conflicting for waiting time < 48 h. The aim of this study was to investigate the association between waiting time to surgery and mortality, with waiting time categorized into 12-hour intervals. Methods: We analysed all hip fractures operated at a large Norwegian hospital between 2015 and 2023. Waiting time from admission to surgery was categorized into 12-hour intervals. Mortality at one week, one month, three months (pre-specified primary endpoint) and one year was assessed using multivariable logistic regression, adjusting for age, sex, nursing home residency, Charlson Comorbidity Index (CCI), fracture type, calendar year of surgery, and direct-acting oral anticoagulant (DOAC) use. Model fit and discrimination were assessed for all models. Results: The study included 4136 hip fractures. At the pre-specified primary endpoint of three months, mortality was numerically higher in patients with waiting times > 12 h, but this did not reach statistical significance for any waiting-time category (adjusted odds ratio [AOR] 1.16-1.25, all p > 0.2). Among the secondary, exploratory endpoints, the one-year timepoint showed increased mortality with increased waiting: patients operated between 12 and 24 h had significantly higher one-year mortality (AOR 1.38, 95% CI 1.10-1.72), rising to an AOR of 1.80 (95% CI 1.20-2.71) for waiting times exceeding 48 h. Conclusions: In this cohort, waiting time beyond 12 h was associated with a higher one-year mortality, but the association was not statistically significant at the primary endpoint at three months. Given the observational design and the possibility of residual confounding, these findings should be interpreted with caution. (© 2026. The Author(s).) |
| Competing Interests: | Declarations. Ethical approval: According to Norwegian legislation, this study is classified as quality control research, and approval of the research has been done by the relevant internal bodies and the data protection officer of the hospital. Ethics: The study was conducted in accordance with the principles of the Declaration of Helsinki, and inclusion in the project was not associated with any conceivable harm. Consent to participate: The database is classified as a quality control database, and written consent is not required under current Norwegian regulations governing quality registries. Competing interests: The authors declare no competing interests. |
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| Contributed Indexing: | Keywords: Comorbidity; Hip fracture; Mortality; Surgical delay; Waiting time |
| Entry Date(s): | Date Created: 20260923 Date Completed: 20260923 Latest Revision: 20260926 |
| Update Code: | 20260926 |
| PubMed Central ID: | PMC13601112 |
| DOI: | 10.1007/s00068-026-03351-w |
| PMID: | 42776226 |
| Database: | MEDLINE |
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