Does the weekend have an influence? Early mortality after hip fracture in the Spanish National Hip Fracture Registry (RNFC)

Hip fractures are among the orthopaedic injuries leading to the greatest morbidity and mortality in older adults; their impact in older populations like Spain, which has one of the greatest aging rates in Europe, is significant. Audits such as the Spanish National Hip Fracture Registry (Registro Nacional de Fracturas de Cadera, RNFC) aim to improve care quality through data analysis reducing unjustified variability. The weekend effect is one possible factor affecting the care process, with patients managed differently depending on whether they are admitted on weekends or public holidays increasing surgical delay. This study analyses the weekend effect on 30-day mortality of patients at least 75 years old with hip fractures, with a secondary objective of analysing other risk factors. A retrospective analysis was conducted on data from 57,450 patients collected by the RNFC between 2017-2022, with an average surgical delay of 65.26 (SD: 64.92) hours and a 30-day mortality of 8.44%. The sample was divided into the weekend group (admitted Thursday-Sunday and on national holidays) and the weekday group (Monday-Wednesday). There were no differences on mortality between groups, so day of admission were not a risk factor for mortality. Surgical delay instead was longer in the weekend group (68.51 (61.41) hours vs. 61.1 (68.94) hours during the week (p<0.001)), being a risk factor for mortality >48h delay (OR 1.22 [1.14-1.31]). There is no weekend effect on 30-days mortality, despite a longer surgical delay in the weekend group, which was a risk factor for 30-days mortality.