• OBJECTIVES
    • To evaluate the association between the timing of hip fracture surgery with postoperative length of stay and outcomes.
  • DESIGN
    • Retrospective review using the American College of Surgeons National Surgical Quality Improvement Program database.
  • SETTING
    • National inquiry database incorporating 140 academic and private medical centers.
  • PATIENTS
    • Seventeen thousand four hundred fifty-nine patients who underwent surgery for a hip fracture between 2006 and 2013 were identified from the National Surgical Quality Improvement Program database.
  • INTERVENTION
    • Surgical management of hip fractures was performed at the discretion of participating surgeons.
  • OUTCOME MEASURE
    • Thirty-day outcomes including postoperative length of stay, readmission rates, reoperation rates, complications, and mortality rates.
  • RESULTS
    • Of the 17,459 patients, 4107 (23.5%) were operated on within 24 hours, 8740 (50.1%) within 24-48 hours, and 4612 (26.4%) more than 48 hours after hospital admission. Increased time to surgery was associated with longer postoperative hospital length of stay. Prolonged time to surgery did not adversely affect postoperative outcomes.
  • CONCLUSIONS
    • Although a delay in the management of hip fractures is associated with an increase in postoperative hospital length of stay, 30-day postoperative outcomes are not adversely affected in patients undergoing hip fracture fixation.
  • LEVEL OF EVIDENCE
    • Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.