Baseline characteristics of patients by timing of surgery
| Characteristic | All patients n = 139 119* | Timing of surgery; no. (%) of patients | |||
|---|---|---|---|---|---|
| Day of admission n = 32 120 | Inpatient day 2 n = 60 505 | Inpatient day 3 n = 29 236 | After 3 days n = 17 258 | ||
| Age, yr | |||||
| 65–74 | 20 827 (15.0) | 5112 (15.9) | 8997 (14.9) | 4223 (14.4) | 2495 (14.5) |
| 75–84 | 54 506 (39.2) | 12 499 (38.9) | 23 701 (39.2) | 11 475 (39.2) | 6831 (39.6) |
| 85–94 | 56 353 (40.5) | 12 743 (39.7) | 24 514 (40.5) | 12 032 (41.2) | 7064 (40.9) |
| ≥95 | 7433 (5.3) | 1766 (5.5) | 3293 (5.4) | 1506 (5.2) | 868 (5.0) |
| Gender† | |||||
| Women | 103 405 (74.3) | 24 245 (75.5) | 45 393 (75.0) | 21 480 (73.5) | 12 287 (71.2) |
| Men | 35 699 (25.7) | 7873 (24.5) | 15 106 (25.0) | 7754 (26.5) | 4966 (28.8) |
| Prefracture health status | |||||
| Home without comorbidity | 62 291 (44.8) | 14 534 (45.2) | 27 655 (45.7) | 13 024 (44.5) | 7078 (41.0) |
| Home with comorbidity‡ | 18 275 (13.1) | 3247 (10.1) | 7048 (11.6) | 4475 (15.3) | 3505 (20.3) |
| Home care | 3295 (2.4) | 680 (2.1) | 1521 (2.5) | 711 (2.4) | 383 (2.2) |
| Long-term care facility | 29 258 (21.0) | 6755 (21.0) | 12 816 (21.2) | 6164 (21.1) | 3523 (20.4) |
| Elsewhere | 26 000 (18.7) | 6904 (21.5) | 11 465 (18.9) | 4862 (16.6) | 2769 (16.0) |
| Comorbidity§ | |||||
| Cardiac dysrhythmias | 11 220 (8.1) | 1823 (5.7) | 4190 (6.9) | 2941 (10.1) | 2266 (13.1) |
| COPD | 4765 (3.4) | 993 (3.1) | 1937 (3.2) | 1020 (3.5) | 815 (4.7) |
| Diabetes mellitus | 4738 (3.4) | 875 (2.7) | 1892 (3.1) | 1092(3.7) | 879 (5.1) |
| Heart failure | 9198 (6.6) | 1585 (4.9) | 3359 (5.6) | 2244 (7.7) | 2010 (11.6) |
| Hypertension | 7267 (5.2) | 1442 (4.5) | 2976 (4.9) | 1677 (5.7) | 1172 (6.8) |
| Ischemic heart disease, acute | 6664 (4.8) | 1267 (3.9) | 2702 (4.5) | 1453 (5.0) | 1242 (7.2) |
| Ischemic heart disease, chronic | 1912 (1.4) | 361 (1.1) | 695 (1.1) | 443 (1.5) | 413 (2.4) |
| Hospital type¶ | |||||
| Teaching | 54 212 (39.0) | 8189 (25.5) | 23 335 (38.6) | 14 182 (48.5) | 8506 (49.3) |
| Community large | 63 975 (46.0) | 17 078 (53.2) | 28 322 (46.8) | 11 925 (40.8) | 6650 (38.5) |
| Community medium | 19 513 (14.0) | 6541 (20.4) | 8221 (13.6) | 2875 (9.8) | 1876 (10.9) |
| Annual hospital volume** | |||||
| Lower for its type | 34 231 (24.6) | 9044 (28.2) | 14 697 (24.3) | 6712 (23.0) | 3778 (21.9) |
| Higher for its type | 104 888 (75.4) | 23 076 (71.8) | 45 808 (75.7) | 22 524 (77.0) | 13 480 (78.1) |
| Timing of admission†† | |||||
| Weekday 12 am to 06:59 am | 15 020 (10.8) | 6763 (21.1) | 4969 (8.2) | 2074 (7.1) | 1214 (7.0) |
| Weekday 7 am to 3:59 pm | 32 217 (23.2) | 10 486 (32.6) | 12 681 (21.0) | 5602 (19.2) | 3448 (20.0) |
| Weekday 4 pm to 11:59 pm | 53 039 (38.1) | 4785 (14.9) | 25 245 (41.7) | 14 864 (50.8) | 8145 (47.2) |
| Weekend | 38 777 (27.9) | 10 073 (31.4) | 17 591 (29.1) | 6669 (22.8) | 4444 (25.8) |
| Admission status | |||||
| Urgent or emergent | 136 586 (98.2) | 31 294 (97.4) | 59 440 (98.2) | 28 834 (98.6) | 17 018 (98.6) |
| Otherwise | 2533 (1.8) | 826 (2.6) | 1065 (1.8) | 402 (1.4) | 240 (1.4) |
| Surgical demand‡‡ | |||||
| Excess demand | 96 834 (69.6) | 22 326 (69.5) | 41 724 (69.0) | 20 518 (70.2) | 12 266 (71.1) |
| Otherwise | 42 285 (30.4) | 9794 (30.5) | 18 781 (31.0) | 8718 (29.8) | 4992 (28.9) |
| Transfer history | |||||
| No | 127 812 (91.9) | 31 679 (98.6) | 57 352 (94.8) | 25 660 (87.8) | 13 121 (76.0) |
| Yes | 11 307 (8.1) | 441 (1.4) | 3153 (5.2) | 3576 (12.2) | 4137 (24.0) |
| Preoperative procedures | |||||
| No | 125 297 (90.1) | 29 655 (92.3) | 55 225 (91.3) | 25 997 (88.9) | 14 420 (83.6) |
| Yes | 13 822 (9.9) | 2465 (7.7) | 5280 (8.7) | 3239 (11.1) | 2838 (16.4) |
| Fracture type | |||||
| Transcervical | 72 285 (52.0) | 16 075 (50.0) | 31 101 (51.4) | 15 607 (53.4) | 9502 (55.1) |
| Inter- or subtrochanteric | 66 834 (48.0) | 16 045 (50.0) | 29 404 (48.6) | 13 629 (46.6) | 7756 (44.9) |
| Procedure type | |||||
| Fixation | 83 643 (60.1) | 20 208 (62.9) | 36 908 (61.0) | 16 869 (57.7) | 9658 (56.0) |
| Arthroplasty | 55 476 (39.9) | 11 912 (37.1) | 23 597 (39.0) | 12 367 (42.3) | 7600 (44.0) |
| Year of surgery | |||||
| 2004–2006 | 46 563 (33.5) | 11 476 (35.7) | 20 047 (33.1) | 9088 (31.1) | 5952 (34.5) |
| 2007–2009 | 45 746 (32.9) | 10 593 (33.0) | 19 168 (31.7) | 9713 (33.2) | 6272 (36.3) |
| 2010–2012 | 46 810 (33.6) | 10 051 (31.3) | 21 290 (35.2) | 10 435 (35.7) | 5034 (29.2) |
| Province | |||||
| Alberta | 15 281 (11.0) | 3076 (9.6) | 7008 (11.6) | 3415 (11.7) | 1782 (10.3) |
| British Columbia | 26 774 (19.2) | 5813 (18.1) | 12 375 (20.5) | 5830 (19.9) | 2756 (16.0) |
| Manitoba | 7636 (5.5) | 1315 (4.1) | 3673 (6.1) | 1540 (5.3) | 1108 (6.4) |
| New Brunswick | 4774 (3.4) | 1663 (5.2) | 1877 (3.1) | 732 (2.5) | 502 (2.9) |
| Newfoundland and Labrador | 3155 (2.3) | 748 (2.3) | 1341 (2.2) | 717 (2.5) | 349 (2.0) |
| Nova Scotia | 5985 (4.3) | 1917 (6.0) | 2174 (3.6) | 1022 (3.5) | 872 (5.1) |
| Ontario | 67 119 (48.2) | 16 260 (50.6) | 28 390 (46.9) | 14 030 (48.0) | 8439 (48.9) |
| Prince Edward Island | 1028 (0.7) | 366 (1.1) | 363 (0.6) | 184 (0.6) | 115 (0.7) |
| Saskatchewan | 7367 (5.3) | 962 (3.0) | 3304 (5.5) | 1766 (6.0) | 1335 (7.7) |
Note: COPD = chronic obstructive pulmonary disease.
↵* Based on codes for hip fracture surgery from either the Canadian Classification of Interventions (1VA74^^, 1VA53^^, 1VC74^^, 1SQ53^^), or the Canadian Classification of Procedures (9054, 9114, 9134, 9351, 9359, 9361, 9362, 9363, 9364, 9369).
↵† For 15 patients, gender was unknown.
↵‡ The level of care of the facility from which the patient was transferred was identified by “the institution from type” field in the hospital discharge abstracts. Comorbidity is represented by an indicator variable for any of the coexisting conditions listed in the “Comorbidity” section of this table.
↵§ Based on diagnostic codes from all hospital discharge abstracts in the year before the index admission.
↵¶ For 1419 patients, hospital type was unavailable.
↵** We dichotomized hospitals into higher- and lower-volume categories by comparing their annual volumes in the year of index surgery with the median of average annual volumes among hospitals of the same type (174 surgeries for teaching hospitals, 141 for community large hospitals, 37 for community medium hospitals).57,58
↵†† For 66 patients, admission time was unknown.
↵‡‡ The number of admissions in the week of the index admission compared with the hospital’s weekly capacity.