DOS 2017

DOS Kongressen 2017 ·

No association between surgical delay and mortality

following distal femoral fractures. A study from The

Danish Fracture Database Collaboration

Anne Marie Nyholm, Henrik Palm, Thomas Kallemose, Anders Troelsen, Kirill Gro-

mov

Ortopædkirurgisk Afdeling, Hvidovre Hospital

Background:

Surgical delay (SD) in patients with hip fractures has been shown

to increase mortality. However, the effect of increased SD on mortality follow-

ing distal femoral fractures has been sparsely investigated.

Purpose / Aim of Study:

To show if a) SD or b) educational level of surgeon

(ELS) affect mortality rates for patients with a distal femoral fracture.

Materials and Methods:

Patients aged ≥50 years registered in the Danish

Fracture Database for undergoing surgery of a distal femoral fracture (AO33A-

C), excluding pathological, open, or high-energy trauma fractures, were in-

cluded. Data included age, gender, American Society of Anesthesiologists (ASA)

score, type of fracture and, ELS and SD. ELS was defined as “attending or above

as surgeon”, “attending or above as supervisor” or “below attending alone”. SD

was defined as hours (h) from radiological diagnostics until onset of surgery.

Mortality data was provided by The Civil Registration System. Mortality rates

were calculated using multiple logistical regression analysis.

Findings / Results:

Data on 392 surgeries were included: Mean age 76 years

(range 50-101), 79% of patients were female and 65% had an extraarticular

fracture (AO33A). 8% were operated within 12 h, 33% within 24 h, 67% within

48 h and 83% within 72 h. ELS was “attending or above as surgeon” in 56% of all

cases and “attending or above as supervisor” in 33%. Mortality was 7.1% at day

30 and 12.5% at day 90. The logistical regression analysis did not demonstrate

any association between SD or ELS and mortality following surgery for a distal

femoral fracture. Increasing age, male gender and ASA score >2 significantly

increased both 30-day and 90-day mortality.

Conclusions:

No association between SD or ELS, and mortality was found.

These findings do not support the development of guidelines for decreasing SD

in this population.

No conflicts of interest reported

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