So it’s concerning that there are still differences in wait times depending on where you live. It looked at 16 studies that encompassed 13,500 patients over 60, with cutoffs at 24, 48 or 72 hours, and found that earlier surgery was associated with a lower risk of death, lower rates of pneumonia and fewer pressure sores.Ī 2005 study found that every day of delay before surgery increased the odds of dying in hospital by 13%. A more recent systematic review published in the Canadian Medical Association Journal found similar results. The same trends held three months, six months and a year after surgery, and they were even more pronounced in younger, healthier patients. A 2005 study looked at 57,000 hip fracture patients in Ontario and found that surgical delay was a major predictor of death, with every day of delay increasing the odds of dying in hospital by 13%. It’s clear that early surgery is important. It also means we rank fairly well against other OECD countries on this issue, coming in fifth of 23 countries in 2013. “Yes, we’re better than we were, but I’m hopeful that we can make wait times even shorter.” Working to fix unequal accessĪcross the country, we’ve done much better at hitting the 48 hour benchmark for hip surgery, with 87% of people getting surgery within that time in 2015, up significantly from 79% in 2011. “HIP ATTACK treats hip fractures almost like a heart attack: if someone shows up with this problem, you do something for them right away,” explains James Waddell, chair of the Expert Panel for Orthopaedic Surgery for Health Quality Ontario. The trial’s six-hour line sprung out of a finding by UK researcher Martyn Parker, who was stratifying outcomes data by wait times, and found that patients who happened to wait less than six hours did considerably better than others who waited longer. Called HIP ATTACK, it looks at whether treating patients in six hours or less will help reduce complications and death. In some parts of Alberta, rates dip down to 62%.Īnd a major trial in Ontario is now testing whether doing surgery even sooner would result in even better outcomes. In some parts of Ontario, only 75% of patients get their surgery within 48 hours. Canada has done well on pushing towards that two-day goal, but there remains significant variation across the country. Which brings us to the good news: getting surgery for a hip fracture sooner – within 48 hours – can significantly reduce the risk of negative outcomes. “These people are lying in bed, they don’t eat, they’re on strong medication, their circulation deteriorates … there’s a myriad of complications that can happen as a result of that,” explains Don Dick, an orthopedic surgeon and senior medical director of Alberta’s Bone and Joint Strategic Clinical Network. Rather, they’re a result of the time patients spend bedridden waiting to get surgery. Surprisingly, many of those complications are not repercussions of the injury itself. Within a year, 12% to 37% will die, with numbers reflecting ranges in the studies. Within three months of a hip fracture, 6% to 8% will die. Many will suffer complications such as a heart attack, stroke, pneumonia, blood clot or major bleeding. For many of those people, it will mark the beginning of serious health issues. More than 35,000 Canadians suffer from hip fractures every year, and most of them are over 60. If you’re elderly, falling and breaking a hip is a major health risk.
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