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• W4377011114 abstract "Objective: To assess the impact of Friday surgery on clinical outcomes in elderly patients with hip fracture under multidisciplinary treatment. Methods: A retrospective cohort study. The clinical data of 414 geriatric patients with hip fractures admitted to Zhongda Hospital Affiliated with Southeast University from January 2018 to March 2021 were analyzed retrospectively, including 126 males and 288 females with a mean age of (81.3±7.6) years. The patients were divided into two groups based on whether they underwent surgery on Friday or not. The Friday group(n=69) and the non-Friday group(n=345) were compared in terms of general information, American Society of Anesthesiologists(ASA) classification, fracture type, injury to admission time, preoperative waiting time, surgical method, anesthesia type and use of intensive care unit (ICU) fast track. Propensity score matching (PSM) was performed based on age, ASA grade, time from injury to admission, preoperative waiting time, hemoglobin and albumin levels at admission. Clinical outcomes were collected and compared between the two groups, including length of hospital stay, total hospitalization cost and 30-day, 90-day and 1-year mortality rates, and postoperative complications. Multivariate logistic regression analyses were conducted to identify influencing factors for 1-year mortality in geriatric patients with hip fracture. Results: Baseline data showed statistically significant differences in hemoglobin, albumin and preoperative waiting time between the two groups (all P<0.05). After PSM matching, 69 patients were included in each group, and no significant differences were observed in baseline data between the two groups (all P>0.05). There was no significant differences in 30-day mortality rate (4.3% vs 0, P=0.080), 90-day mortality rate (7.2% vs 1.4%, P=0.095), length of hospital stay [(10.85±4.45)d vs (10.92±3.68)d, P=0.919], total hospitalization cost [(60.9±15.4) thousands yuan vs (59.1±15.4) thousands yuan, P=0.489], postoperative complications [pneumonia (11.6% vs 13.0%, P=0.796), cardio-cerebrovascular complications (11.6% vs 8.7%, P=0.573) and delirium (5.7% vs 2.9%, P=0.245)] between the Friday group and the non-Friday group (all P>0.05). However, the 1-year mortality rate was higher in the Friday group than that in the non-Friday group(18.8% vs 4.3%, P=0.008). Multivariate analysis revealed that surgery on Friday (OR=11.222, 95%CI: 2.198-57.291, P=0.004), low hemoglobin levels at admission (OR=0.920, 95%CI: 0.875-0.967, P=0.001), hemiarthroplasty treatment (OR=5.127, 95%CI: 1.308-20.095, P=0.019) and longer surgery duration (OR=0.958, 95%CI: 0.927-0.989, P=0.009) were influencing factors for 1-year mortality in geriatric patients with hip fracture. Conclusions: In the context of multidisciplinary treatment, Friday surgery does not increase short-term mortality, length of hospital stay, total hospitalization cost or incidence of complications in geriatric patients with hip fracture. However, it remains a influencing factor for 1-year mortality in those patients.目的： 探讨多学科诊疗模式下周五手术对老年髋部骨折患者临床结局的影响。 方法： 回顾性队列研究。回顾性分析2018年1月至2021年3月东南大学附属中大医院创伤骨科多学科诊疗模式下收治的414例老年髋部骨折患者临床资料，其中男126例，女288例，年龄（81.3±7.6）岁。根据是否于周五接受手术，将患者分为周五手术组（69例）和非周五手术组（345例）。比较两组一般资料、美国麻醉师协会（ASA）分级、骨折类型、受伤至入院时间、术前等待时间、手术方式、麻醉类型及是否使用重症监护病房（ICU）快通道。根据患者年龄、ASA分级、受伤至入院时间、术前等待时间、入院时血红蛋白和白蛋白量进行倾向性得分匹配。收集并比较两组患者临床结局指标，包括住院时长、住院总花费，并对患者进行为期1年的随访并记录患者30 d、90 d和1年的生存情况以及相关术后并发症发生情况。采用多因素logistic回归分析进一步验证老年髋部骨折患者术后1年死亡率的影响因素。 结果： 基线资料显示两组患者在入院时血红蛋白、白蛋白以及术前等待时间的差异具有统计学意义（均P<0.05）。经倾向性得分匹配后周五手术组及非周五手术组各纳入患者69例，两组患者在基线资料方面的差异无统计学意义（均P>0.05）。两组患者在术后30 d死亡率（4.3%比0，P=0.080）、90 d死亡率（7.2%比1.4%，P=0.095）及总住院时长［（10.85±4.45）d比（10.92±3.68）d，P=0.919］、住院总花费［（60.9±15.4）千元比（59.1±15.4）千元，P=0.489］、术后并发症发生率（肺部感染11.6%比13.0%，P=0.796；心脑血管意外11.6%比8.7%，P=0.573；谵妄5.7%比2.9%，P=0.245）方面差异均无统计学意义（均P>0.05），但周五手术组术后1年死亡率高于非周五手术组（18.8%比4.3%，P=0.008）。多因素分析显示周五手术（OR=11.222，95%CI：2.198~57.291，P=0.004）、入院时血红蛋白（OR=0.920，95%CI：0.875~0.967，P=0.001）、接受人工股骨头置换手术（OR=5.127，95%CI：1.308~20.095，P=0.019）及手术时长（OR=0.958，95%CI：0.927~0.989，P=0.009）是老年髋部骨折患者术后1年死亡率的影响因素（P<0.05）。 结论： 多学科诊疗模式下，周五手术不会增加短期死亡率、总住院时长、住院总花费和术后并发症的发生率，但周五手术仍是老年髋部骨折患者术后1年死亡率的影响因素之一。." @default.
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• W4377011114 date "2023-05-23" @default.
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• W4377011114 title "[Effect of Friday surgery on clinical outcome of elderly patients with hip fracture under multidisciplinary treatment]." @default.
• W4377011114 doi "https://doi.org/10.3760/cma.j.cn112137-20221024-02216" @default.
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