“Accelerated Surgery” for Hip Fractures Produces Modest Benefits

In high-income countries, about 95% of hip fractures are managed surgically. Observational studies have suggested that “accelerated surgery,” within a few hours of diagnosis, is associated with lower risks for major complications and short-term mortality than is standard care.

Researchers enrolled 2970 patients (mean age, 79) in 17 countries who presented during usual working hours with low-energy mechanism hip fractures that required surgery; patients were randomized to accelerated surgery (goal was to operate within 6 hours of diagnosis) or standard care. The median time to surgery in the accelerated-surgery group was 6 hours; in the standard-care group, it was 24 hours.

The primary outcomes, mortality and a composite of major complications…