Effect of weekend admission on geriatric hip fractures

Table 1 Complications included in the analysis of complication rate for hip fracture patients

Complications
Atrial fibrillation
Supraventricular tachycardia
Congestive heart failure exacerbation
Cardiac arrest
Acute kidney injury
Acute cholecystitis
Aspiration pneumonia
Hospital acquired pneumonia
Acute respiratory failure
Gastrointestinal bleed
Esophageal varies
Hematemesis
Pulmonary embolism
Deep venous thrombosis
Sepsis
Systemic inflammatory response syndrome
Cerebrovascular accident
Hemiarthroplasty dislocation

Table 2 Demographics and comorbidities for the weekday and weekend cohorts. Median and interquartile range are given for age

	Weekend		Weekday		P value
n	302		388
Age	85 (77-90)		85 (77-90)		0.8076
Sex
F	213 (70.5)		282 (72.7)		0.5515
ASA classification
1	0 (0)		2 (0.5)		0.2523
2	47 (15.6)		76 (19.6)
3	184 (60.9)		233 (60.1)
4	71 (23.5)		77 (19.9)
Hyperlipidemia	80 (26.5)		148 (38.1)		0.0014
Diabetes mellitus	81 (26.8)		93 (24.0)		0.4267
Renal disease	55 (18.2)		72 (18.6)		0.9215
Dementia	85 (28.2)		93 (24.0)		0.2206
Depression	29 (9.6)		36 (9.3)		0.8962
Cardiac disease	132 (43.7)		170 (43.8)		1
Respiratory disease	57 (18.9)		49 (12.6)		0.0257
Cancer	30 (9.9)		54 (13.9)		0.1274

n (%) of females in each cohort are given for gender. P values reflect Fisher’s Exact tests, with the exception of age, which represents a Wilcoxon rank sum test. ASA: American Society of Anesthesiologists.

Table 3 Breakdown of procedures performed for the weekday and weekend cohorts, n (%)

	Total	Intracapsular fractures	Trochanteric fractures	Short nail	Long nail	HA	THA	CS	SHS
Weekday	388 (100)	135 (34.8)	253 (65.2)	183 (47.2)	74 (19.1)	71 (18.3)	16 (4.1)	33 (8.5)	11 (2.8)
Weekend	302 (100)	97 (32.1)	205 (67.9)	153 (50.7)	54 (17.9)	56 (18.5)	8 (2.6)	25 (8.3)	6 (2.0)

A Fisher’s exact test comparing the distributions between the two cohorts yielded a P value of 0.8309. HA: Hemiarthroplasty; THA: Total hip arthroplasty; CS: Cannulated screw fixation; SHS: Sliding hip screw.

Table 4 Comparison of the primary and secondary outcome measures between the weekday and weekend cohorts

	Weekend	Weekday	P value
LOS (d)	5 (4-7)	5 (4-7)	0.2734
Time from optimization to surgery (h)	13.9 (5.9-23.0)	10.8 (4.6-21.0)	0.0172a
Time from ED to optimization (h)	22.7 (13.9-40.6)	20.0 (13.9-26.4)	0.0015a
Time from ED to surgery (h)	42.7 (24.6-63.7)	32.5 (24.1-45.9)	< 0.0001a
Complication rate	40 (13.3)	32 (8.3)	0.044a
Transfusion rate	86 (28.5)	112 (28.9)	0.9325
Mortality rate	6 (2.0)	4 (1.0)	0.3460

LOS, time from optimization to surgery, time from ED to Optimization, and time from ED to surgery are given as median and interquartile range. Complication rate, transfusion rate, and mortality rate are given as numbers and then percentages. All outcome measures were compared between cohorts using Fisher’s exact tests. Of note, mortality rate remained the same (P = 0.4530) and complication rate remained different (P = 0.0273) between the two cohorts when multivariate logistic regression was performed.

^aP < 0.05. LOS: Length of stay; ED: Emergency department.