Description
In this lecture, Jan-Erik Gjertsen, an orthopedic surgeon from Bergen, Norway, discusses the critical issue of hip fractures and the significance of timely surgical intervention. He begins by outlining the concerning statistics surrounding mortality rates post-hip fracture, which can be as high as 30% within a year, emphasizing the urgent need for optimized treatment for these vulnerable patients. Gjertsen highlights that most studies have focused on the time frame from diagnosis or admission to surgery, but he suggests a more effective metric would be measuring the time from the actual fracture to surgery.
He illustrates the fine balance needed between minimizing surgical delays and maintaining high-quality treatment, referring to visual aids that demonstrate ideal vs. unsuitable waiting times. The lecture cites several studies establishing a direct correlation between surgical delays and increased mortality rates, presenting evidence that patients waiting longer than 48 hours face significantly heightened risks.
Gjertsen also shares findings from his own research through the Norwegian Hip Fracture Register, which indicates that patients treated within 48 hours had no increase in one-year mortality rates, reinforcing the need for a swift response to fractures.
In discussing various factors affecting surgical timing, he notes the importance of prioritizing patients who experience longer waits prior to hospital admission, along with addressing systemic challenges such as operating room availability and staffing constraints.
Additionally, Gjertsen references guidelines from the Association of Anesthetists in Great Britain and Ireland, underscoring acceptable and unacceptable reasons for delaying hip fracture surgeries. He advocates for proactive cooperation with anesthetists to ensure patients are medically optimized for timely surgery. Ultimately, Gjertsen concludes that while prompt treatment is essential, it should not compromise the quality of care, and that surgeries need not be conducted at night to meet the timeline, emphasizing patient welfare and optimal outcomes.