The Impact of Increased Time to Surgery in Geriatric Patients With Acetabular Fractures

J Orthop Trauma. 2023 Jun 1;37(6):270-275. doi: 10.1097/BOT.0000000000002568.


Objectives: To explore the association between time to surgery (TTS) and postoperative complications in geriatric patients with acetabular fractures.

Design: Retrospective cohort study.

Setting: Level I trauma center.

Patients/participants: 51 consecutive geriatric patients (60 years of age or older) who presented to a Level 1 trauma center for surgical fixation of an acetabular fracture between 2013 and 2020.

Main outcome measurement: The primary and secondary outcomes were 30-day postoperative complications and length of hospital stay (LOS), respectively. TTS was determined by time between arrival to ED and time of surgery, with a threshold of 48 hours (early vs. delayed TTS group).

Results: Nineteen patients (37.3%) had ≥1 postoperative complications. Patients in the delayed TTS group had 5× higher odds of developing ≥1 complications (odds ratio: 4.86, confidence interval: 1.48-15.96). There were no 30-day mortalities in either group. Patients in the delayed TTS group had an average LOS of 19 days compared with early TTS patients who had an average LOS of 12 days ( P = 0.040).

Conclusion: Geriatric patients with acetabular fractures with delayed TTS had increased postoperative complications and LOS. These data suggest that expedited care may have a similar protective effect in geriatric patients with acetabular fractures, as it does in the acute hip fracture population.

Level of evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

MeSH terms

  • Aged
  • Fractures, Bone* / complications
  • Hip Fractures* / epidemiology
  • Humans
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Spinal Fractures* / complications