Impact of Surgical Management Delay on Morbidity and Mortality of Proximal Femoral Fractures in Elderly Patients

Abstract

Background: Fractures of the proximal femur (FPF) represent a significant public health concern, particularly among the elderly population. Despite advancements in surgical interventions, mortality rates remain high, necessitating an understanding of the impact of surgical management delay on patient outcomes. Material and Methods: This retrospective study, conducted at the Mohammed V Military Training Hospital, involved 125 patients aged over 50 years who underwent surgery for FPF between January 2018 and June 2021. Data collection utilized clinical records and statistical analysis was performed using Jamovi software. Results: The majority of patients (67.0%) presented with femoral neck fractures, with a male predominance (59%). Surgical management delay was categorized as less than 48 hours, between two days and one week, and more than one week. Comparison of management within 48 hours versus after 48 hours revealed significant associations with late complications (p=0.021) and one-year mortality (p=0.014). Multivariate analysis identified delayed care (>48 hours) as independently associated with postoperative morbidity and mortality (p=0.015, OR=3.122). Conclusion: Timely surgical intervention is paramount in mitigating the morbidity and mortality burden associated with proximal femoral fractures. Multidisciplinary collaboration and proactive risk factor identification are essential for optimizing patient care and outcomes. Healthcare policies should prioritize strategies to minimize surgical management delays, thereby improving patient outcomes and quality of life.