Effect of timing of surgery on postoperative complications and prognosis in elderly patients with hip fractures.

Background: In clinical practice, there is no standardized criteria for the optimal timing of hip fracture surgery in the elderly, and there is much controversy. Objectives: To investigate the effect of timing of surgery on postoperative complications and prognosis in elderly patients with hip fractures. Methods: Retrospectively analyzed 636 elderly hip fracture patients over 65 years old. The patients were divided into early group (< 3 days), intermediate group (3-7 days) and late group (> 7 days) according to the time from fracture to surgery, and the three groups were compared with the postoperative in-hospital general conditions, the occurrence of complications, the efficacy and the prognosis. p < 0.05 indicates that the difference is statistically significant. Results: Postoperative hospitalization was significantly shorter in the early group than in the intermediate and late groups (9.5 ± 4.2 d vs. 11.9 ± 3.7 d vs. 13.3 ± 4.5 d, p < 0.05). The incidence of postoperative lung infection (2.7% vs. 6.3% vs. 8.4%), deep vein thrombosis (3.9% vs. 6.7% vs. 11.6%), stress ulcers (1.9% vs. 3.6% vs. 7.1%), and pressure ulcers (2.3% vs. 6.7% vs. 7.7%) was the lowest in the early group, followed by the intermediate group, and the highest in the late group (p < 0.05). In-hospital mortality was lower in the early group than in the intermediate and late groups (3.5% vs. 8.0% vs. 10.3%). In addition, at 1 month postoperatively, Harris scores were significantly higher in the early group than in the intermediate group (87.1 ± 5.3 vs. 82.2 ± 5.6, p < 0.001) and in the intermediate group than in the late group (82.2 ± 5.6 vs. 78.4 ± 5.0, p = 0.008). At 1 year postoperatively, the mortality rate was lower in the early group than in the intermediate and late groups (2.4% vs. 6.8% vs. 7.2%). Conclusion: Early surgery reduces the incidence of postoperative complications in elderly hip fracture patients, shortens hospitalization time, facilitates early recovery of hip function, and reduces mortality within 1 year after surgery.