RELATIONSHIPS BETWEEN THE DELAY BEFORE SU RGERY FOR A HIP FRACTURE, POSTOPERATIVE COMPLICATIONS AND RISK OF DEATH

The objective was to describe the relationship between preoperative de lay, postoperative complications, and risk of death at 6 months. The p opulation is constitued of 200 subjects aged 65 years or older who wer e living at home and treated for a hip fracture in any of three of Que bec's hospitals between April, 1(rst), 1987 and March, 31, 1989. Chi-s quare or F-test, and linear and logistic regression were used to test the relationship between the variables. Preoperative delays varied fro m 2 to 403 h (median, 45 h). Variations between hospitals were particu larly important; median delay at hospital 1 was 209 h, at hospital 2, 36 h, at hospital 3, 30,5 h. Only 5% of the variance of the delay was explained by the subjects' characteristics before the fracture. The re lationships between delay and postoperative complications are not sign ificant. However, the risk of death at 6 months increased with the len gth of operative delay; the observed increase tends to be linear (p = 0,03). These results suggest first, that surgery for hip fracture had to be consider as an urgency second, that it could be none 36 hours or less after the arrival at hospital.