Association between Preoperative Waiting Times of Less Than 24 Hours versus 24 to 48 Hours and Clinical Outcomes in Elderly Patients Underwent Hip Fracture Surgery: A Single Center Randomized Controlled Trial

Objective: Delayed surgical intervention following a hip fracture in the elderly patients may increase the risk of complications and mortality. The present study aimed to investigate the association between surgery within 24 hours versus 24 to 48 hours post-injury and clinical outcomes within the first month after surgery. Materials and Methods: The present study was a randomized controlled trial (RCT) study conducted at Yasothon Hospital. Elderly patients diagnosed with hip fractures were randomized into two groups, the intervention group who underwent surgery within 24 hours and the control group who underwent surgery between 24 and 48 hours. Both groups were followed up for one month postoperatively. The outcomes were the postoperative oral morphine equivalent amount, mortality rate, length of hospital stays, and postoperative complications. Results: Ninety-four patients were enrolled, with 47 patients in each group. Statistically significant differences were observed between the two groups in terms of hip fracture type (p<0.001), ASA classification (p=0.032), fixation method (p<0.001), operation time (p=0.002), and type of anesthesia used (p=0.020). Additionally, patients who underwent surgery within 24 hours had a significantly shorter length of hospital stay compared to those who underwent surgery between 24 and 48 hours (p<0.001). However, there were no statistically significant differences in postoperative oral morphine equivalent amount (p=0.137), one-month mortality rate (p=0.153), or postoperative complication rates (p=1.000) between the two groups. Conclusion: Early hip fracture surgery within 24 hours for elderly patients can improve clinical outcomes, yet, surgery within the standard 48-hour period still yields similarly favorable outcomes. These findings could support more efficient hospital resource management while ensuring patient safety remains a priority.