{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T02:34:34Z","timestamp":1780108474029,"version":"3.54.0"},"reference-count":29,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2018,5,1]],"date-time":"2018-05-01T00:00:00Z","timestamp":1525132800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Orthop Surg (Hong Kong)"],"published-print":{"date-parts":[[2018,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Early surgery for older adults with hip fracture has been shown to improve outcomes. We aim to study the factors contributing to delay in surgery (defined as surgery performed more than 48 h after admission) and its associated outcomes in a tertiary hospital in Singapore with an integrated hip fracture program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This is a prospective cohort study of hip fracture patients aged more than 60 years over 1 year. We collected data on demographics, premorbid mobility and functional status, time to surgery, postoperative complications, and inhospital mortality. Mortality data and functional performance were reviewed at 1 year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>High American Society of Anaesthesiologists score independently predicted delay in surgery (odd ratio (OR) = 9.52, 95% confidence interval (CI): 1.69\u201353.68). Delayed surgery was significantly associated with longer length of stay (median 12.8 days with interquartile range (IQR) 9.7\u201317.6 days vs. 8.35 days with IQR 5.9\u201310.9 days, p &lt; 0.01). Surgery within 48 h significantly reduced functional decline (Modified Barthel Index change \u22123.89 \u00b1 17.23 vs. \u22129.29 \u00b1 20.30, p = 0.01) and 1-year mortality (3.5% vs. 9.3%, p = 0.03). Surgical delay was an independent risk factor for early postoperative complications (OR = 3.21, 95% CI: 1.21\u20138.49), and patients were significantly less likely to return to premorbid mobility at 1 year (OR = 0.62, 95% CI: 0.39\u20130.97).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Delayed hip fracture surgery in older adults is associated with worse short- and long-term outcomes, including early postoperative complications and poorer functional recovery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2309499018783909","type":"journal-article","created":{"date-parts":[[2018,6,28]],"date-time":"2018-06-28T21:34:13Z","timestamp":1530221653000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Beyond comanaged inpatient care to community integration: Factors leading to surgical delay in hip fractures and their associated outcomes"],"prefix":"10.1177","volume":"26","author":[{"given":"Nathalie","family":"Declarador","sequence":"first","affiliation":[{"name":"Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rani","family":"Ramason","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Tay","sequence":"additional","affiliation":[{"name":"Department of General Medicine (Geriatric Medicine), Sengkang Health, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai Lim William","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest Beng Kee","family":"Kwek","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,6,28]]},"reference":[{"key":"bibr1-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1007\/BF01623184"},{"key":"bibr2-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.307.6914.1248"},{"key":"bibr3-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1177\/2151458510378105"},{"key":"bibr4-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-013-1900-9"},{"key":"bibr5-2309499018783909","unstructured":"American Association of Orthopaedic Surgeons. Evidence-based Clinical Practice Guideline: Management of Hip Fractures in the Elderly.Available at: http:\/\/www.aaos.org\/Research\/guidelines\/HipFxGuideline.pdf. (2014, accessed 5 August 2016)."},{"key":"bibr6-2309499018783909","unstructured":"British Orthopaedic Association. The care of patients with fragility fracture. Available at: http:\/\/www.fractures.com\/pdf\/BOA-BGS-Blue-Book.pdf. (2007, accessed 5 August 2016)."},{"key":"bibr7-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"bibr8-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(89)90065-6"},{"key":"bibr9-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-1166(200003)15:3<234::AID-GPS99>3.0.CO;2-G"},{"key":"bibr10-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/20.5.332"},{"key":"bibr11-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/77.2.217"},{"key":"bibr12-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000221"},{"key":"bibr13-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000313"},{"key":"bibr14-2309499018783909","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-4-201108160-00006"},{"key":"bibr15-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2011.03725.x"},{"key":"bibr16-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2009.02377.x"},{"key":"bibr17-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.91B7.22446"},{"key":"bibr18-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0046175"},{"key":"bibr19-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.092220"},{"key":"bibr20-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e3182a5a045"},{"key":"bibr21-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1177\/2151458514555570"},{"issue":"1","key":"bibr22-2309499018783909","first-page":"6","volume":"22","author":"Man LP","year":"2016","journal-title":"Hong Kong Med J"},{"key":"bibr23-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1093\/geronj\/45.3.M101"},{"key":"bibr24-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1997.tb00942.x"},{"key":"bibr25-2309499018783909","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.00890"},{"key":"bibr26-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1016\/j.jotr.2013.08.005"},{"key":"bibr27-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2008.02023.x"},{"key":"bibr28-2309499018783909","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2009.02455.x"},{"key":"bibr29-2309499018783909","unstructured":"Currie C, Partridge M, Plant F, The national hip fracture database national report. London, 2012."}],"container-title":["Journal of Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2309499018783909","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2309499018783909","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2309499018783909","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:25:19Z","timestamp":1777595119000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2309499018783909"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5,1]]},"references-count":29,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,5,1]]}},"alternative-id":["10.1177\/2309499018783909"],"URL":"https:\/\/doi.org\/10.1177\/2309499018783909","relation":{},"ISSN":["1022-5536","2309-4990"],"issn-type":[{"value":"1022-5536","type":"print"},{"value":"2309-4990","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5,1]]},"article-number":"2309499018783909"}}