Variable | Adjusted increase or decrease in wait time (95% CI), h |
---|---|
Patient characteristic | |
Age, per yr | 0.042 (0.023 to 0.061) |
Female sex | −1.11 (−1.50 to −0.710) |
Rural residence | −0.200 (−0.874 to 0.476) |
Income quintile (1 [lowest] v. 5 [highest]) | 0.041 (−0.511 to 0.592) |
Income quintile (2 v. 5) | −0.182 (−0.746 to 0.382) |
Income quintile (3 v. 5) | −0.032 (−0.604 to 0.540) |
Income quintile (4 v. 5) | 0.364 (−0.206 to 0.934) |
Medical comorbidity | |
Charlson group (v. no previous hospital admissions) | |
0 | 1.01 (0.494 to 1.528) |
1 | 1.13 (0.553 to 1.704) |
2 | 1.438 (0.752 to 2.125) |
3 | 2.19 (1.55 to 2.83) |
Frailty | 0.368 (−0.162 to 0.900) |
Diabetes | 0.081 (−0.331 to 0.494) |
Hypertension | 0.501 (0.037 to 0.966) |
Chronic obstructive pulmonary disease | 0.140 (−0.329 to 0.609) |
Coronary artery disease | 0.628 (−0.084 to 1.34) |
Congestive heart failure | 3.10 (2.63 to 3.57) |
Preadmission institutionalization | 0.267 (−0.157 to 0.692) |
Antiplatelet or anticoagulant prescription† | 5.80 (5.31 to 6.29) |
Injury characteristics | |
Polytrauma (ISS ≥ 16) | −1.67 (−3.72 to 0.353) |
Subtrochanteric fracture (v. femoral neck) | 0.275 (−0.653 to 1.20) |
Intertrochanteric fracture (v. femoral neck) | 0.335 (−0.195 to 0.866) |
Physician characteristics | |
Surgeon | |
No. of cases of hip fracture in previous yr | −0.025 (−0.033 to −0.017) |
Years since Canadian orthopedic certification | −0.028 (−0.047 to −0.009) |
Preoperative workup | |
Preoperative consultation with internal medicine | 6.43 (6.06 to 6.80) |
Preoperative consultation with anesthesia | 5.90 (5.48 to 6.33) |
Preoperative echocardiogram | 18.56 (17.73 to 19.38) |
Type of surgery | |
Arthroplasty (v. intramedullary nail) | −1.68 (−2.25 to −1.12) |
Sliding hip screw or cannulated screws (v. intramedullary nail) | 0.884 (0.154 to 1.61) |
System characteristics | |
Hospital | |
Patient transferred from another facility | 26.24 (25.38 to 27.09) |
No. of cases of hip fracture in previous yr | −0.014 (−0.017 to −0.012) |
Mean no. of urgent surgeries per d | 1.08 (0.947 to 1.21) |
Academic (v. medium community hospital) | 3.15 (2.52 to 3.78) |
Large (v. medium community hospital) | 4.20 (3.73 to 4.66) |
Timing of presentation | |
Admission over weekend | −2.71 (−3.10 to −2.32) |
After-hours presentation (v. working hours) | −1.68 (−2.22 to −1.14) |
Overnight presentation (v. working hours) | 1.00 (0.621 to 1.38) |
Year of surgery | |
2009 (v. 2013) | 1.53 (0.970 to 2.09) |
2010 (v. 2013) | 2.49 (1.94 to 3.05) |
2011 (v. 2013) | 1.42 (0.874 to 1.97) |
2012 (v. 2013) | 0.265 (−0.275 to 0.805) |
Note: CI = confidence interval, ISS = Injury Severity Score.
↵* We conducted the analysis for 40 508 patients (without statistical outliers; see Appendix 1C, available at www.cmaj.ca/lookup/suppl/doi:10.1503/cmaj.170830/-/DC1).
We adjusted all regression models for the following covariates: age, sex, year of surgery, income quintile, Charlson group, frailty, diabetes, coronary artery disease, chronic obstruction pulmonary disease, coronary artery disease, preadmission institutionalization, Injury Severity Score, and fracture and surgery type.
↵† Calculated in a separate linear regression model that was restricted to patients for whom prescription receipts were available (those aged 65 yr or older).