The aim of this study was to investigate the association of surgical delay and comorbidities with the risk of mortality after hip fracture surgeries. We found that CCI was the dominant factor in predicting both short- and long-term mortality, and its effect is vital in the prognostication of survivorship. INTRODUCTION Hip fracture is a growing concern and a delay in surgery is often associated with a poorer outcome. We hypothesized that a higher Charlson Comorbidity Index (CCI) portends greater risk of mortality than a delay in surgery. Our aim was to investigate the associations of surgical delay and CCI with risk of mortality and to determine the dominant predictor. METHODS This retrospective study examines hip fracture data from a large tertiary hospital in Singapore over the period January 2013 through December 2015. Data collected included age, gender, CCI, delay of surgery, fracture patterns, and the American Society of Anaesthesiologist (ASA) score. Post-operative outcomes analyzed included mortality at inpatient, at 30 and 90 days, and at 2 years. RESULTS A total of 1004 patients with hip fractures were included in this study. Study mortality rates were 1.1% (n = 11) during in-hospital admission, 1.8% (n = 18) at 30 days, 2.7% (n = 27) at 90 days, and 13.3% (n = 129) at 2 years. Lost to follow-up rate at 2 years was 3.3%. We found that CCI was consistently the dominant factor in predicting both short- and long-term mortality. A CCI score of 5 was identified as the inflection point above which comorbidity at baseline presented a greater risk of mortality than a delay in surgery. CONCLUSION Our analysis showed that CCI is the dominant predictor of both short- and long-term mortality compared with delay in surgery. The effect of CCI is vital in the prognostication of mortality in patients surgically treated for hip fractures.

中文翻译：

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合并症是髋部骨折手术后死亡率的主要预测因素。

本研究的目的是调查手术延迟和合并症与髋部骨折手术后死亡风险的关系。我们发现，CCI 是预测短期和长期死亡率的主要因素，其作用对于预测生存率至关重要。引言 髋部骨折越来越受到关注，手术延迟通常与较差的结果相关。我们假设较高的 Charlson 合并症指数 (CCI) 预示着比手术延迟更大的死亡风险。我们的目的是调查手术延迟和 CCI 与死亡风险的关系，并确定主要的预测因素。方法 这项回顾性研究检查了 2013 年 1 月至 2015 年 12 月期间新加坡一家大型三级医院的髋部骨折数据。收集的数据包括年龄、性别、CCI、手术延迟、骨折模式和美国麻醉医师协会 (ASA) 评分。分析的术后结果包括住院、30 天和 90 天以及 2 年的死亡率。结果本研究共纳入髋部骨折患者1004例。入院期间研究死亡率为 1.1% (n = 11)，30 天时为 1.8% (n = 18)，90 天时为 2.7% (n = 27)，2 年时为 13.3% (n = 129) . 2年失访率为3.3%。我们发现 CCI 始终是预测短期和长期死亡率的主要因素。CCI 评分为 5 分被确定为拐点，在该拐点之上，基线合并症比手术延迟表现出更大的死亡风险。结论 我们的分析表明，与手术延迟相比，CCI 是短期和长期死亡率的主要预测因素。CCI 对髋部骨折手术治疗患者死亡率的预测至关重要。