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Furthermore, internal fixation and arthroplasty were compared to determine if a difference could be observed in patients operated with these techniques at different times during the day.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>All patients above 18 of age\u00a0years in Sweden who underwent hip fracture surgery between 2008 and 2017 were eligible for inclusion. Pathological fractures, non-operatively managed fractures, or cases whose time of surgery was missing were excluded. The cohort was subdivided into on-hour (08:00\u201317:00) and out-of-hours surgery (17:00\u201308:00). Poisson regression with adjustments for confounders was used to evaluate the association between out-of-hours surgery and both 30-day and 90-day postoperative mortality.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Out-of-hours surgery was associated with a 5% increase in the risk of both 30-day [adj. IRR (95% CI) 1.05 (1.00\u20131.10), <jats:italic>p<\/jats:italic>\u2009=\u20090.040] and 90-day [adj. IRR (95% CI) 1.05 (1.01\u20131.09), <jats:italic>p<\/jats:italic>\u2009=\u20090.005] mortality after hip fracture surgery compared to on-hour surgery. There was no statistically significant association between out-of-hours surgery and postoperative mortality among patients who received an internal fixation. Arthroplasties performed out-of-hours were associated with a 13% increase in 30-day postoperative mortality [adj. IRR (95% CI) 1.13 (1.04\u20131.23), <jats:italic>p<\/jats:italic>\u2009=\u20090.005] and an 8% increase in 90-day postoperative mortality [adj. IRR (95% CI) 1.08 (1.01\u20131.15), <jats:italic>p<\/jats:italic>\u2009=\u20090.022] compared to on-hour surgery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Out-of-hours surgical intervention is associated with an increase in both 30- and 90-day postoperative mortality among hip fracture patients who received an arthroplasty, but not among patients who underwent internal fixation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00068-021-01804-y","type":"journal-article","created":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T05:11:55Z","timestamp":1633669915000},"page":"709-719","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["The consequences of out-of-hours hip fracture surgery: insights from a retrospective nationwide study"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3583-3443","authenticated-orcid":false,"given":"Maximilian Peter","family":"Forssten","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3436-1026","authenticated-orcid":false,"given":"Ahmad","family":"Mohammad Ismail","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Borg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Wretenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary Alan","family":"Bass","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7097-487X","authenticated-orcid":false,"given":"Shahin","family":"Mohseni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,10,7]]},"reference":[{"key":"1804_CR1","doi-asserted-by":"publisher","first-page":"1333","DOI":"10.2106\/JBJS.O.00029","volume":"97","author":"AM Nyholm","year":"2015","unstructured":"Nyholm AM, Gromov K, Palm H, Brix M, Kallemose T, Troelsen A, et al. 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