Increased mortality risk at 90 days and final follow-up seen in association with delayed disposition
By Elana Gotkine HealthDay Reporter
THURSDAY, Oct. 10, 2024 (HealthDay News) — For patients with hip fracture, delayed admission is associated with increased mortality risk, according to a study published online Oct. 8 in Emergency Medicine Journal.
Nicholas D. Clement, M.B.B.S., M.D., Ph.D., from the Royal Infirmary of Edinburgh in the United Kingdom, and colleagues undertook a single-center evaluation involving patients aged older than 50 years who were admitted to a Scottish hospital through the emergency department with a hip fracture from January 2019 to June 2022 to examine the impact of delayed admission, defined as spending more than four hours in the emergency department from arrival.
The cohort included 3,266 patients (mean age, 81 years); 38.6 percent had delayed admission. The researchers identified 1,314 deaths (40.2 percent) during a median follow-up of 529 days. Survival at 90 days was significantly lower for patients with versus without delayed admission (92.9 versus 95.7 percent; hazard ratio, 0.76). There was an independent association for delayed disposition with increased mortality risk at 90 days and final follow-up (adjusted hazard ratios, 1.36 and 1.15, respectively). There was also an association for delay with longer length of hospital stay (difference in medians of one day). No differences were seen in the risk for delirium on the ward or return to place of residence.
“There was an association between emergency department waiting time and poorer hip fracture outcomes,” the authors write. “Adoption of emergency department-accelerated care pathways in our institution may help improve their outcomes.”
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