{"id":20754,"date":"2024-11-27T11:01:00","date_gmt":"2024-11-27T16:01:00","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=20754"},"modified":"2024-11-27T11:36:46","modified_gmt":"2024-11-27T16:36:46","slug":"language-and-surgical-wait-time-and-outcomes-among-older-adults-with-hip-fracture","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/language-and-surgical-wait-time-and-outcomes-among-older-adults-with-hip-fracture\/","title":{"rendered":"Language preference, surgical wait time, and outcomes among older adults with hip fracture"},"content":{"rendered":"<p><strong>Importance<\/strong> \u2014 Patients with a non-English language preference served within English-dominant health care settings are at increased risk of adverse events that may result from communication barriers and inequitable access to care.<\/p>\n<p><strong>Objective<\/strong> \u2014 To examine the association between non-English language preference with surgical wait time and post-operative outcomes in older patients undergoing hip fracture repair.<\/p>\n<p><strong>Design <\/strong>\u2014 A population-based, retrospective cohort study using linked databases to measure surgical wait time and post-operative outcomes among older adults who underwent hip fracture surgery between January 1, 2017 and December 31, 2022. We used propensity-based overlap weighting, accounting for baseline patient characteristics, to compare primary and secondary outcomes.<\/p>\n<p><strong>Setting<\/strong> \u2014 A retrospective population-based cohort study in Ontario, Canada. Participants: Community-dwelling older adults (66 years of age or older). Exposure: Non-English language preference.<\/p>\n<p><strong>Outcomes<\/strong> \u2014 Our primary outcome was surgical delay beyond 24 hours. Secondary outcomes included time to surgery, surgical delay beyond 48 hours, post-operative medical complications, length of stay, discharge destination, 30-day mortality, and 30-day hospital readmission.<\/p>\n<p><strong>Results<\/strong> \u2014 Among 35,238 patients who underwent hip fracture surgery, 28,815 (81.8%) were English speakers (mean [SD] age 84.4 [8.0] years; 19,965 women [69.3%]) and 6,423 (18.2%) were non-English speakers (mean [SD] age 85.5 [7.0] years; 4,556 women [70.9%]). The median [IQR] wait time for surgery was similar for English (24 [16-41] hours) and non-English speakers (25 [16-42] hours). There was no significant difference in surgical delay beyond 24 hours between English and non-English speaking patients (51.7% vs. 50.3%, adjusted relative risk [aRR] 1.00, 95% confidence interval [CI] 0.98-1.03). Compared to English speakers, patients with a non-English language preference had increased risk of delirium (18.8% vs. 14.6%, RR 1.10, 95% CI 1.03-1.17), myocardial infarction (0.7% vs. 0.5%, aRR 1.52, 95% CI 1.04-2.22), longer length of stay (11 vs 10 days, aRR 1.11, 95% CI 1.06-1.15), and more frequent discharge to a nursing home (7.0% vs 6.8%, aRR 1.13, 95% CI 1.01-1.27).<\/p>\n<p><strong>Conclusions and relevance<\/strong> \u2014 In this cohort study of older adults undergoing hip fracture surgery, non-English language preference was associated with increased risk of delirium, myocardial infarction, longer length of stay and discharge to a nursing home. These findings indicate inequities in hip fracture care for patients with a non-English language preference.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Importance \u2014 Patients with a non-English language preference served within English-dominant health care settings are at increased risk of adverse events that may result from communication barriers and inequitable access to care. Objective \u2014 To examine the association between non-English language preference with surgical wait time and post-operative outcomes in older patients undergoing hip fracture [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[25],"migration-helper-qa-sample-set":[],"class_list":["post-20754","journal_article","type-journal_article","status-publish","hentry","topic-surgery"],"acf":{"citation":"Reppas-Rindlisbacher C, Boblitz A, Podolsky S, Fowler RA, Lapointe-Shaw L, Sheehan KA, Stukel TA, Stall NM, Rochon PA. <em><span class=\"highlight\">JAMA<\/span>\u00a0Netw\u00a0<\/em><span class=\"highlight\"><em>Open<\/em>. 2024; Nov 27.<\/span>","source_url":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.48010","ices_scientist":[1234,1287,1372,1340],"site":[6733],"research_program":[6740],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":[20757],"video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Language preference, surgical wait time, and outcomes among older adults with hip fracture<\/title>\n<meta name=\"description\" content=\"Importance \u2014 Patients with a non-English language preference served within English-dominant health care settings are at increased risk of adverse events\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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