Relationship between Time to Surgery and Functional Outcome in Hip Fractures among Older Adults

Abstract

Background: Hip fractures among older adults are associated with substantial morbidity, functional disability, and prolonged hospitalization. Surgical timing may influence postoperative recovery and complications.

Aim: To evaluate the relationship between time to surgery and functional outcomes among older adults with hip fractures.

Materials and Methods: This prospective comparative observational study included 110 patients aged ≥60 years with hip fractures requiring surgical intervention. Patients were categorized into early surgery (≤48 hours, n=55) and delayed surgery (>48 hours, n=55) groups. Functional outcomes were assessed using the Harris Hip Score (HHS) at 6 weeks, 3 months, and 6 months. Postoperative mobility, hospitalization duration, and complications were also evaluated.

Results: Mean admission-to-surgery intervals were 30.6 ± 9.4 and 79.8 ± 24.6 hours in the early and delayed surgery groups, respectively. Early surgery was associated with higher HHS at 6 weeks (68.4 ± 8.6 vs. 59.6 ± 9.2), 3 months (82.4 ± 7.8 vs. 73.2 ± 8.4), and 6 months (88.2 ± 6.9 vs. 80.1 ± 7.6). Excellent or good functional outcomes were achieved in 83.6% versus 54.5% of patients. Independent ambulation (76.4% vs. 54.5%) and return to prefracture mobility (74.5% vs. 52.7%) were more frequent following early surgery. Total hospitalization was shorter (7.5 ± 2.3 vs. 10.7 ± 3.2 days), with fewer postoperative complications.

Conclusion: Early hip fracture surgery within 48 hours was associated with better functional recovery, improved mobility, shorter hospitalization, and fewer complications. Timely surgical intervention should be prioritized alongside appropriate medical optimization.