An epidemiological study of the relationship between time to surgery and health status for elderly patients with a hip fracture

A hip fracture causes permanent changes to life style for older people, including premature death. Two important mortality indicators found post-operatively for this group include, the time until surgery after fracture, and pre-operative health status prior to surgery. Yet no research is available investigating relationships between time to surgery and health status. The researchers aimed to establish a study of the health status risks for patients aged over 65 years with a non-pathological hip fracture to guide nursing care interventions and to test the feasibility of the methods and procedures for later use in a larger study. A prospective cohort design was used to investigate relationships between time to surgery and measures of pre-operative health status including, skin integrity risk, vigour, mental state, bowel function and continence. Twenty-nine patients with a mean age in years of 81.93 (SD, 9.49), were recruited. The mean number of hours from diagnosis to surgery was 52.72 (SD, 58.35) and the range was 1 h to 219 h. At two hours before surgery, the mean scores of vigour and skin integrity risk were significantly higher than at diagnosis, indicating poorer health status. A change in health status occurred, but, possibly due to the small sample size, it was difficult to relate this result to time. However the results informed pre-operative care prior to surgery, for this group.