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Surgical timing is a key modifiable factor influencing outcomes, but fracture-specific data \u2013 particularly for trochanteric fractures \u2013 remains limited. Moreover, concerns regarding the safety of nighttime surgery may contribute to procedural delays.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study investigates how time to surgery and timing of surgery (day vs. night) affect in-hospital complication and mortality rates in patients undergoing trochanteric fracture fixation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      This nationwide registry study included 7,184 patients who underwent closed reduction and internal fixation for a trochanteric femur fracture. Patient demographics, surgical details, hospitalization characteristics, and discharge data were analyzed. Patients were stratified by preoperative interval (&lt;\u200924 vs. &gt;24\u00a0h) and surgery starting time (day vs. night). The primary outcome was in-hospital complications; secondary outcome was in-hospital mortality. Unpaired t-tests, chi-square tests, and backward stepwise binary logistic regression were performed (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 considered significant).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients were predominantly elderly, chronically ill women with statutory insurance. The overall in-hospital complication rate was 17%, and the mortality rate was 3.4%. Surgery delayed beyond 24\u00a0h was associated with higher complication rates, longer operative times and hospital stays, and lower discharge mobility. Delay was an independent risk factor for complications and was associated with increased mortality, though not independently. No significant differences were observed between day and night surgeries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Our fracture-specific findings align with current clinical guidelines: surgery within 24\u00a0h leads to better in-hospital outcomes. Delays were linked to a 38% rise in complications and a 74% increase in mortality. Nighttime surgery was demonstrated to be safe and should not be avoided without medical justification. The study\u2019s limitations include its retrospective design and its focus on in-hospital outcomes only.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Minimizing surgical delay for trochanteric fractures is fundamental. System-level improvements and interdisciplinary coordination are needed to ensure timely care. Given the aging population, the implementation of streamlined treatment pathways is increasingly important.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00068-025-03012-4","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T17:07:56Z","timestamp":1763140076000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["In-hospital outcome after trochanteric femur fractures is related to preoperative delay but not to the time of day of the procedure: a nationwide retrospective cohort study of 7184 patients"],"prefix":"10.1007","volume":"51","author":[{"given":"Valentina","family":"Egger","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Sophie","family":"Mittlmeier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Canal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentin","family":"Neuhaus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"issue":"12","key":"3012_CR1","doi-asserted-by":"publisher","first-page":"1726","DOI":"10.1007\/s00198-006-0172-4","volume":"17","author":"O Johnell","year":"2006","unstructured":"Johnell O, Kanis JA. 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