{"id":3453,"date":"2017-11-28T00:00:00","date_gmt":"2017-11-28T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/association-between-wait-time-and-30-day-mortality-in-adults-undergoing-hip-fracture-surgery\/"},"modified":"2023-06-14T19:33:47","modified_gmt":"2023-06-14T23:33:47","slug":"association-between-wait-time-and-30-day-mortality-in-adults-undergoing-hip-fracture-surgery","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-wait-time-and-30-day-mortality-in-adults-undergoing-hip-fracture-surgery\/","title":{"rendered":"Association between wait-time and 30-day mortality in adults undergoing hip fracture surgery"},"content":{"rendered":"<p><strong>Importance<\/strong> &#x2014; Although wait-times for hip fracture surgery have been linked to mortality and are being used as quality-of-care indicators worldwide, controversy exists about the duration of the wait that leads to complications.<\/p>\n<p><strong>Objective <\/strong>&#x2014; Use population-based wait-time data to identify the optimal time window in which to conduct hip fracture surgery before the risk of complications increases.<\/p>\n<p><span class=\"bold\">Design, Setting, and Participants<\/span> &#x2014; Population-based, retrospective cohort study of adults undergoing hip fracture surgery between April 1, 2009 and March 31, 2014 at 72 hospitals in Ontario, Canada.<\/p>\n<p><strong>Exposure<\/strong> &#x2014; Time elapsed from hospital arrival to surgery (in hours).<\/p>\n<p><strong>Main Outcome Measure<\/strong> &#x2014; Mortality within 30 days. Secondary outcomes included a composite of mortality or other medical complications (MI, DVT, PE, and pneumonia).<\/p>\n<p><strong>Analysis<\/strong> &#x2014; Risk-adjusted restricted cubic splines modeled the probability of each complication according to wait-time. The inflection point (in hours) when complications began to increase was used to define &#x2018;early&#x2019; and &#x2018;delayed&#x2019; surgery. To evaluate the robustness of this definition, outcomes amongst propensity-score matched early and delayed patients were compared using percent absolute risk differences (% ARDs, with 95% confidence intervals [CIs]).<\/p>\n<p><strong>Results<\/strong> &#x2014; Among 42,230 patients with hip fracture (mean [SD] age, 80.1 [10.7], 70.5% women) who met study entry criteria, overall mortality at 30 days was 7.0%. The risk of complications increased when wait-times were greater than 24 hours, irrespective of the complication considered. Compared to 13,731 propensity-score matched patients who received surgery earlier, 13,731 patients receiving surgery after 24 hours had a significantly higher risk of 30-day mortality (N=898 (6.5%) versus N=790 (5.8%), % ARD 0.79 [95% CI 0.23 to 1.35]) and the composite outcome (N=1,680 (12.2%) versus N=1,383 (10.1%), % ARD 2.16 [95% CI 1.43 to 2.89]).<\/p>\n<p><span class=\"bold\">Conclusions and Relevance <\/span>&#x2014; Among adults undergoing hip fracture surgery, increased wait-time was associated with a greater risk for 30-day mortality and other complications. A wait-time of 24 hours may represent a threshold defining higher risk.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Importance &#x2014; Although wait-times for hip fracture surgery have been linked to mortality and are being used as quality-of-care indicators worldwide, controversy exists about the duration of the wait that leads to complications. Objective &#x2014; Use population-based wait-time data to identify the optimal time window in which to conduct hip fracture surgery before the risk [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-3453","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Pincus D, Ravi B, Wasserstein D, Huang A, Paterson JM, Nathens AB, Kreder HJ, Jenkinson RJ, Wodchis WP. <em>JAMA. <\/em>2017; 318(20):1994-2003. Epub 2017 Nov 28.","source_url":"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2664460","ices_scientist":[1100,1303,1148,1135,1333,1102],"site":[6733],"research_program":[6746],"news_release":[7613],"journal_article":[],"atlas":[],"research_report":[],"infographic":[9439],"video":[],"downloads":null,"links":null,"sitecore_item_id":"B243C06C-08FF-4F86-9CB7-479C52BD6C5E","sitecore_item_name":"Association-between-wait-time-and-30-day-mortality-in-adults-undergoing-hip-fracture-surgery","sitecore_field_values":"{\n  \"__Valid from\": \"20171201T092725\",\n  \"Title\": \"Association between wait-time and 30-day mortality in adults undergoing hip fracture surgery\",\n  \"Short title\": \"Association between wait-time\",\n  \"Summary\": \"Among adults undergoing hip fracture surgery, increased wait-time was associated with a greater risk for 30-day mortality and other complications.\",\n  \"Citation\": \"<p>Pincus D, Ravi B, Wasserstein D, Huang A, Paterson JM, Nathens AB, Kreder HJ, Jenkinson RJ, Wodchis WP. <em>JAMA. <\/em>2017; 318(20):1994-2003. Epub 2017 Nov 28.<\/p>\",\n  \"Abstract\": \"<p><strong>Importance<\/strong> &mdash; Although wait-times for hip fracture surgery have been linked to mortality and are being used as quality-of-care indicators worldwide, controversy exists about the duration of the wait that leads to complications.<\/p>n<p><strong>Objective <\/strong>&mdash; Use population-based wait-time data to identify the optimal time window in which to conduct hip fracture surgery before the risk of complications increases.<\/p>n<p><span class=\"bold\">Design, Setting, and Participants<\/span> &mdash; Population-based, retrospective cohort study of adults undergoing hip fracture surgery between April 1, 2009 and March 31, 2014 at 72 hospitals in Ontario, Canada.<\/p>n<p><strong>Exposure<\/strong> &mdash; Time elapsed from hospital arrival to surgery (in hours).<\/p>n<p><strong>Main Outcome Measure<\/strong> &mdash; Mortality within 30 days. Secondary outcomes included a composite of mortality or other medical complications (MI, DVT, PE, and pneumonia).<\/p>n<p><strong>Analysis<\/strong> &mdash; Risk-adjusted restricted cubic splines modeled the probability of each complication according to wait-time. The inflection point (in hours) when complications began to increase was used to define &lsquo;early&rsquo; and &lsquo;delayed&rsquo; surgery. To evaluate the robustness of this definition, outcomes amongst propensity-score matched early and delayed patients were compared using percent absolute risk differences (% ARDs, with 95% confidence intervals [CIs]).<\/p>n<p><strong>Results<\/strong> &mdash; Among 42,230 patients with hip fracture (mean [SD] age, 80.1 [10.7], 70.5% women) who met study entry criteria, overall mortality at 30 days was 7.0%. The risk of complications increased when wait-times were greater than 24 hours, irrespective of the complication considered. Compared to 13,731 propensity-score matched patients who received surgery earlier, 13,731 patients receiving surgery after 24 hours had a significantly higher risk of 30-day mortality (N=898 (6.5%) versus N=790 (5.8%), % ARD 0.79 [95% CI 0.23 to 1.35]) and the composite outcome (N=1,680 (12.2%) versus N=1,383 (10.1%), % ARD 2.16 [95% CI 1.43 to 2.89]).<\/p>n<p><span class=\"bold\">Conclusions and Relevance <\/span>&mdash; Among adults undergoing hip fracture surgery, increased wait-time was associated with a greater risk for 30-day mortality and other complications. A wait-time of 24 hours may represent a threshold defining higher risk.<\/p>n<p><a href=\"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2664460\" title=\"opens external link\">View full text<\/a><\/p>\",\n  \"Research Programs\": \"{CFE36C89-C969-4C23-B5E4-1BA9E5BDC273}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{4A1034A0-5248-46A2-805E-20FBC57B1237}|{8294E309-4E31-4325-875E-EE6B86DF7F4C}|{F6861DC9-1AF2-4474-B02F-DDF6C62B2911}|{26C6C411-14DA-4E2F-9D10-9564115ADE0A}|{BB285A10-5E8D-49BA-88DB-2B010AB6CB2F}|{FE03BA58-6C37-4432-9939-1BA2FB3F997A}\",\n  \"Posted Date\": \"20171128T000000\",\n  \"Show on Publications Landing Page\": \"1\",\n  \"In The News\": \"{22FBD057-82C6-4E0C-AF48-8D0C6A46B2EC}|{DABF277B-7E1B-46DE-8014-FFAC60B6A5B6}\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2017\/November\/Association-between-wait-time-and-30-day-mortality-in-adults-undergoing-hip-fracture-surgery"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Association between wait-time and 30-day mortality in adults undergoing hip fracture surgery<\/title>\n<meta name=\"description\" content=\"Importance &#x2014; Although wait-times for hip fracture surgery have been linked to mortality and are being used as quality-of-care indicators worldwide,\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-wait-time-and-30-day-mortality-in-adults-undergoing-hip-fracture-surgery\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Association between wait-time and 30-day mortality in adults undergoing hip fracture surgery\" \/>\n<meta property=\"og:description\" content=\"Importance &#x2014; Although wait-times for hip fracture surgery have been linked to mortality and are being used as quality-of-care indicators worldwide,\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-wait-time-and-30-day-mortality-in-adults-undergoing-hip-fracture-surgery\/\" \/>\n<meta property=\"og:site_name\" content=\"ICES\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ICESOntario\/\" \/>\n<meta property=\"article:modified_time\" content=\"2023-06-14T23:33:47+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/association-between-wait-time-and-30-day-mortality-in-adults-undergoing-hip-fracture-surgery\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/association-between-wait-time-and-30-day-mortality-in-adults-undergoing-hip-fracture-surgery\\\/\",\"name\":\"ICES | Association between wait-time and 30-day mortality in adults undergoing hip fracture surgery\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\"},\"datePublished\":\"2017-11-28T05:00:00+00:00\",\"dateModified\":\"2023-06-14T23:33:47+00:00\",\"description\":\"Importance &#x2014; Although wait-times for hip fracture surgery have been linked to mortality and are being used as quality-of-care indicators worldwide,\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/association-between-wait-time-and-30-day-mortality-in-adults-undergoing-hip-fracture-surgery\\\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/association-between-wait-time-and-30-day-mortality-in-adults-undergoing-hip-fracture-surgery\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/association-between-wait-time-and-30-day-mortality-in-adults-undergoing-hip-fracture-surgery\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Journal Articles\",\"item\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Association between wait-time and 30-day mortality in adults undergoing hip fracture surgery\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\",\"name\":\"ICES\",\"description\":\"POPULATION-BASED HEALTH RESEARCH THAT MAKES A DIFFERENCE\",\"publisher\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#organization\"},\"alternateName\":\"Institute for Clinical Evaluative Sciences\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"fr-FR\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#organization\",\"name\":\"ICES\",\"alternateName\":\"Institute for Clinical Evaluative Sciences\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/wp-content\\\/uploads\\\/2023\\\/04\\\/ices-logo.png\",\"contentUrl\":\"https:\\\/\\\/www.ices.on.ca\\\/wp-content\\\/uploads\\\/2023\\\/04\\\/ices-logo.png\",\"width\":\"676\",\"height\":\"618\",\"caption\":\"ICES\"},\"image\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/ICESOntario\\\/\",\"https:\\\/\\\/www.linkedin.com\\\/company\\\/ices-research-institute\\\/\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"ICES | Association between wait-time and 30-day mortality in adults undergoing hip fracture surgery","description":"Importance &#x2014; Although wait-times for hip fracture surgery have been linked to mortality and are being used as quality-of-care indicators worldwide,","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-wait-time-and-30-day-mortality-in-adults-undergoing-hip-fracture-surgery\/","og_locale":"fr_FR","og_type":"article","og_title":"ICES | Association between wait-time and 30-day mortality in adults undergoing hip fracture surgery","og_description":"Importance &#x2014; Although wait-times for hip fracture surgery have been linked to mortality and are being used as quality-of-care indicators worldwide,","og_url":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-wait-time-and-30-day-mortality-in-adults-undergoing-hip-fracture-surgery\/","og_site_name":"ICES","article_publisher":"https:\/\/www.facebook.com\/ICESOntario\/","article_modified_time":"2023-06-14T23:33:47+00:00","og_image":[{"width":1200,"height":675,"url":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-wait-time-and-30-day-mortality-in-adults-undergoing-hip-fracture-surgery\/","url":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-wait-time-and-30-day-mortality-in-adults-undergoing-hip-fracture-surgery\/","name":"ICES | Association between wait-time and 30-day mortality in adults undergoing hip fracture surgery","isPartOf":{"@id":"https:\/\/www.ices.on.ca\/fr\/#website"},"datePublished":"2017-11-28T05:00:00+00:00","dateModified":"2023-06-14T23:33:47+00:00","description":"Importance &#x2014; Although wait-times for hip fracture surgery have been linked to mortality and are being used as quality-of-care indicators worldwide,","breadcrumb":{"@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-wait-time-and-30-day-mortality-in-adults-undergoing-hip-fracture-surgery\/#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-wait-time-and-30-day-mortality-in-adults-undergoing-hip-fracture-surgery\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-wait-time-and-30-day-mortality-in-adults-undergoing-hip-fracture-surgery\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.ices.on.ca\/fr\/"},{"@type":"ListItem","position":2,"name":"Journal Articles","item":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/"},{"@type":"ListItem","position":3,"name":"Association between wait-time and 30-day mortality in adults undergoing hip fracture surgery"}]},{"@type":"WebSite","@id":"https:\/\/www.ices.on.ca\/fr\/#website","url":"https:\/\/www.ices.on.ca\/fr\/","name":"ICES","description":"POPULATION-BASED HEALTH RESEARCH THAT MAKES A DIFFERENCE","publisher":{"@id":"https:\/\/www.ices.on.ca\/fr\/#organization"},"alternateName":"Institute for Clinical Evaluative Sciences","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.ices.on.ca\/fr\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Organization","@id":"https:\/\/www.ices.on.ca\/fr\/#organization","name":"ICES","alternateName":"Institute for Clinical Evaluative Sciences","url":"https:\/\/www.ices.on.ca\/fr\/","logo":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/www.ices.on.ca\/fr\/#\/schema\/logo\/image\/","url":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2023\/04\/ices-logo.png","contentUrl":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2023\/04\/ices-logo.png","width":"676","height":"618","caption":"ICES"},"image":{"@id":"https:\/\/www.ices.on.ca\/fr\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/ICESOntario\/","https:\/\/www.linkedin.com\/company\/ices-research-institute\/"]}]}},"_links":{"self":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/journal_article\/3453","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/journal_article"}],"about":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/types\/journal_article"}],"acf:post":[{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/infographic\/9439"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/news_release\/7613"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/research_program\/6746"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/site\/6733"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1102"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1333"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1135"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1148"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1303"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1100"}],"wp:attachment":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/media?parent=3453"}],"wp:term":[{"taxonomy":"migration-helper-automated","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-helper-automated?post=3453"},{"taxonomy":"migration-manual","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-manual?post=3453"},{"taxonomy":"topic","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/topic?post=3453"},{"taxonomy":"migration-helper-qa-sample-set","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-helper-qa-sample-set?post=3453"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}