Daytime versus after-hours surgery outcomes in hip fracture patients: a systematic review and meta-analysis.
After-hours surgery
Daytime surgery
Hip fracture
Surgical delay
Journal
Aging clinical and experimental research
ISSN: 1720-8319
Titre abrégé: Aging Clin Exp Res
Pays: Germany
ID NLM: 101132995
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
28
02
2020
accepted:
26
05
2020
pubmed:
6
6
2020
medline:
26
11
2020
entrez:
6
6
2020
Statut:
ppublish
Résumé
Several studies found that hip fracture patient outcome is greatly influenced by the time from admission to surgery. To avoid surgical delay, surgery for hip fracture may be performed at night or weekends. However, after-hours surgery may lead to a reduction in support staff and to surgeon fatigue, which ultimately increases mortality and complications. Therefore, we wanted to compare the outcomes of daytime and after-hours surgery in hip fracture patients. A literature search was performed in the Cochrane Library, and the Web of Science, PubMed, Embase, and Springer databases from inception to December 2019. Relevant studies comparing the results of operations performed at different time periods were included. The main clinical outcomes included total complications, mortality, blood loss, surgical time, and length of hospitalization. Data were pooled, and a meta-analysis was completed. Nine retrospective cohort studies and one randomized controlled trial met the inclusion criteria; the studies included a total of 583,290 patients. We found no significant differences in mortality, surgical time or blood loss between daytime and after-hours surgery in hip fracture patients (P > 0.05). Of note, the patients who underwent after-hours surgery had fewer surgical complications (P < 0.001) and a shorter length of hospitalization (P = 0.021) than those who underwent daytime surgery. After-hours surgery for hip fracture is safe. To avoid surgical delay, after-hours surgery is still a viable and even necessary option.
Sections du résumé
BACKGROUND
BACKGROUND
Several studies found that hip fracture patient outcome is greatly influenced by the time from admission to surgery. To avoid surgical delay, surgery for hip fracture may be performed at night or weekends. However, after-hours surgery may lead to a reduction in support staff and to surgeon fatigue, which ultimately increases mortality and complications. Therefore, we wanted to compare the outcomes of daytime and after-hours surgery in hip fracture patients.
METHODS
METHODS
A literature search was performed in the Cochrane Library, and the Web of Science, PubMed, Embase, and Springer databases from inception to December 2019. Relevant studies comparing the results of operations performed at different time periods were included. The main clinical outcomes included total complications, mortality, blood loss, surgical time, and length of hospitalization. Data were pooled, and a meta-analysis was completed.
RESULTS
RESULTS
Nine retrospective cohort studies and one randomized controlled trial met the inclusion criteria; the studies included a total of 583,290 patients. We found no significant differences in mortality, surgical time or blood loss between daytime and after-hours surgery in hip fracture patients (P > 0.05). Of note, the patients who underwent after-hours surgery had fewer surgical complications (P < 0.001) and a shorter length of hospitalization (P = 0.021) than those who underwent daytime surgery.
CONCLUSION
CONCLUSIONS
After-hours surgery for hip fracture is safe. To avoid surgical delay, after-hours surgery is still a viable and even necessary option.
Identifiants
pubmed: 32500366
doi: 10.1007/s40520-020-01611-2
pii: 10.1007/s40520-020-01611-2
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
2427-2438Commentaires et corrections
Type : CommentIn
Type : CommentIn
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