{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T18:41:13Z","timestamp":1786300873855,"version":"build-2736575974"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES:<\/jats:title>\n                    <jats:p>To investigate whether first-line CT imaging, as an alternative to standard radiography, reduces the time from admission to surgery in patients suspected of a proximal femoral fracture without classic clinical signs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Single center Level 2 trauma center, Slagelse Hospital, Region Zealand, Denmark.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient Selection Criteria:<\/jats:title>\n                    <jats:p>Patients aged 65 years and above, admitted between June 1, 2018, and May 31, 2019, undergoing radiography and\/or CT of the proximal femur AO\/OTA 31 or pelvis AO\/OTA 61 were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome Measure and Comparisons:<\/jats:title>\n                    <jats:p>The primary outcome was comparing time from admission to surgery, mortality, and fracture distribution between the 2 groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Nine hundred twenty-seven patients were included, 452 patients before and 475 after the new imaging guideline. After the implementation of this new imaging guideline, there was a significant decrease in time from arrival at the emergency department to surgery from 1229 to 1050 minutes (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.03). Patients time to surgery was 179 minutes faster than before, a savings of approximately 3 hours and the reduced time to surgery did not lead to a significant difference on the 30-day (before = 13.23, after = 18.03 days,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.29) and 1-year (before = 106.3, after = 133.45 days,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.21) mortality rate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>The new imaging guideline decreased the time from arrival at the emergency department to surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LEVEL OF EVIDENCE:<\/jats:title>\n                    <jats:p>Prognostic, Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/bot.0000000000003182","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T13:00:42Z","timestamp":1775826042000},"page":"e181-e185","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Computed Tomography Scan as First-Line Imaging in Patients Suspected of a Proximal Femoral Fracture Without Obvious Clinical Findings\u2014A Cohort Study of 927 Patients"],"prefix":"10.1097","volume":"40","author":[{"given":"Frederikke R.","family":"Jars","sequence":"first","affiliation":[{"name":"Clinical Research, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristoffer B.","family":"Hare","sequence":"additional","affiliation":[{"name":"Regional Health Research, University of Southern Denmark, Odense, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20260809","doi-asserted-by":"crossref","first-page":"1583","DOI":"10.1007\/s00198-007-0403-3","article-title":"Increased mortality in patients with a hip fracture-effect of pre-morbid conditions and post-fracture complications","volume":"18","author":"Vestergaard","year":"2007","journal-title":"Osteoporos Int"},{"key":"R2-20260809","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.1016\/j.injury.2018.04.015","article-title":"Epidemiology and social costs of hip fracture","volume":"49","author":"Veronese","year":"2018","journal-title":"Injury"},{"key":"R3-20260809","doi-asserted-by":"crossref","first-page":"2239","DOI":"10.1007\/s00198-012-1964-3","article-title":"A systematic review of hip fracture incidence and probability of fracture worldwide","volume":"23","author":"Kanis","year":"2012","journal-title":"Osteoporos Int"},{"key":"R4-20260809","doi-asserted-by":"crossref","first-page":"11","DOI":"10.5371\/hp.2020.32.1.11","article-title":"Timing of hip-fracture surgery in elderly patients: literature review and recommendations","volume":"32","author":"Seong","year":"2020","journal-title":"Hip Pelvis"},{"key":"R6-20260809","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.2214\/AJR.09.3295","article-title":"Radiographic detection of hip and pelvic fractures in the emergency department","volume":"194","author":"Kirby","year":"2010","journal-title":"Am J Roentgenol"},{"key":"R7-20260809","doi-asserted-by":"crossref","first-page":"e000560","DOI":"10.1136\/tsaco-2020-000560","article-title":"Accuracy of plain radiography in detecting fractures in older individuals after low-energy falls: current evidence","volume":"5","author":"Pedersen","year":"2020","journal-title":"Trauma Surg Acute Care Open"},{"key":"R8-20260809","first-page":"179","article-title":"Use of CT vs. MRI for diagnosis of hip or pelvic fractures in elderly patients after low energy trauma","volume":"39","author":"Eggenberger","year":"2019","journal-title":"Iowa Orthop J"},{"key":"R9-20260809","doi-asserted-by":"crossref","first-page":"1324","DOI":"10.2214\/AJR.19.21510","article-title":"Diagnostic performance of CT for occult proximal femoral fractures: a systematic review and meta-analysis","volume":"213","author":"Kellock","year":"2019","journal-title":"Am J Roentgenol"},{"issue":"suppl 1","key":"R11-20260809","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/BOT.0000000000001063","article-title":"Fracture and dislocation classification Compendium-2018","volume":"32","author":"Meinberg","year":"2018","journal-title":"J Orthop Trauma"},{"key":"R12-20260809","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1016\/S0140-6736(20)30058-1","article-title":"Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial","volume":"395","author":"Borges","year":"2020","journal-title":"Lancet"},{"key":"R13-20260809","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1007\/s00590-015-1666-6","article-title":"Prospective study of the reproducibility of X-rays and CT scans for assessing trochanteric fracture comminution in the elderly: a series of 110 cases","volume":"25","author":"Isida","year":"2015","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"R14-20260809","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1016\/j.injury.2020.02.088","article-title":"Hip fractures in the winter - 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