Delay to Surgery of Less Than 12 Hours Is Associated With Improved Short- and Long-Term Survival in Moderate- to High-Risk Hip Fracture Patients

Introduction: The effect of delays before surgery of 24 hours, 48 hours, and 72 hours on short- and long-term survival has been investigated comprehensively in hip fracture patients, but with controversial results. However, there is only limited evidence for how a threshold of 12-hour delay before hip fracture surgery affects survival. Materials and Methods: A prospective observational study of 884 consecutive hip fracture patients (age >= 65 years) undergoing surgery was carried out in terms of 30- and 365-day survival. A Cox hazard regression survival model was constructed for 724 patients with American Society of Anesthesiologists score >= 3 with adjustments of age, gender, cognition, number of medications on admission, hip fracture type, and prior living arrangements. Results: Patients who underwent surgery within 12 hours had better chances of survival than did those with 12 to 24 hours (hazard ratio [HR]: 8.30; 95% confidence interval [CI]: 1.13-61.4), 24 to 48 hours (HR: 7.21; 95% CI: 0.98-52.9), and >48 hours (HR: 11.75; 95% CI: 1.53-90.2) delay before surgery. Long-term survival was more influenced by nonadjustable patient features, but the adverse effect of >48 hours delay before surgery was noticed with HR: 2.02; 95% CI: 1.08-3.80. Increased age and male gender were significantly associated with worse short- and long-term survival. Discussion/Conclusions: Early hip fracture surgery within 12 hours of admission is associated with improved 30-day survival among patients with ASA score >= 3. Delay to surgery of more than 48 hours has an adverse effect on 365-day survival, but factors related to patients' comorbidities have a great influence on long-term survival

Changes in nutritional status and associated factors in a geriatric post-hip fracture assessment

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The prevalence and risk factors of overactive bladder symptoms and its relation to pelvic organ prolapse symptoms in a general female population

Contains fulltext : 98453.pdf (publisher's version ) (Closed access)INTRODUCTION AND HYPOTHESIS: To study the prevalence and risk factors of overactive bladder (OAB) symptoms and its relationship with symptoms of pelvic organ prolapse (POP). METHODS: This is a cross-sectional study including women aged between 45 and 85 years, registered in eight general practices. All women were asked to self complete the validated Dutch translated questionnaires. All symptoms were dichotomized as present or absent based on responses to each symptom and degree of bother. RESULTS: Forty-seven percent of the women filled out the questionnaire. Prevalence of urgency was 34% and the prevalence of any OAB symptoms 49%. Prevalence of OAB symptoms increased with advancing age. Symptoms of POP were an independent risk factor for symptomatic OAB. Other risk factors were continence and prolapse surgery in the past, age above 75, overweight, postmenopausal status and smoking. CONCLUSIONS: The prevalence of any OAB symptoms was 49%. POP symptoms were an independent risk factor for symptomatic OAB