Surgical delay is not associated with increased mortality in Greenlandic hip fracture patients: a 5-year retrospective cohort study.
7 affiliations
- 1Department of Orthopedics, Surgical Department, Queen Ingrids Hospital, Nuuk, Greenland.
- 2Arctic Health Research Centre, Aalborg University Hospital, Aalborg, Denmark.
- 3Department of Cardiothoracic Surgery, Copenhagen University Hospital - Rigshospitalet, Denmark.
- 4Department of Orthopedics and Traumatology, Hospital Lillebaelt, Kolding, Denmark.
- 5Institute of Regional Health Services, University of Southern Denmark, Odense, Denmark.
- 6Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland.
- 7Department of Internal Medicine, Queen Ingrid's Hospital, Nuuk, Greenland.
Abstract
Hip fractures are associated with increased morbidity and mortality. Guidelines recommend surgery within 24 h, but Greenland's vast geography and Arctic weather often delay surgical treatment. Our aims were (1) to describe the time until surgery among hip fracture patients in Greenland and (2) to evaluate its association with 30-day and 1-year mortality. All patients with hip fracture ICD-10 codes DS720, DS721 and DS722 from 2018 through 2022 were included. Data on time of diagnosis, time to operation, reason for delay, ASA score, Charlson Comorbidity Index (CCI), and time of death were collected from patient records. Crude and adjusted analyses were performed. Among 262 patients, the mean time to surgery was 91.4 h, and more than 24 h delay occurred in 90% of them. Mortality did not increase with surgical delay (30 days, OR = 1.0, 95% CI 0.8-1.1; 1 year, OR = 0.9, 0.8-1.1). Mortality rates were comparable to a parallel Danish cohort (30-day mortality of 9.9% vs 10.8% and 1-year mortality of 29.4% vs 28%), with distinctly shorter delays. Mortality was raised with a worse ASA score 3 (OR = 3.8, 1.9-7.4; p < 0.001) and CCI (OR = 3.1, 1.6-5.9; p = 0.001), and with age >70 years (OR = 2.5, 95% CI 1.1-5.9; p = 0.032). The constraint of vast distances and harsh weather in the Arctic causes long surgical delays in hip fracture patients, yet the inability to meet the surgical timeline recommended did not adversely affect mortality in hip fracture patients in Greenland. This questions a general need for fast-track surgery in resource-limited areas.
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BibTeX
@article{hansen2026surgical,
title = {{Surgical delay is not associated with increased mortality in Greenlandic hip fracture patients: a 5-year retrospective cohort study.}},
author = {Elisabeth Charlotte Hansen and Steen-Erik Christensen and Frank Damborg and Ane Simony and Stig Andersen},
journal = {International journal of circumpolar health},
year = {2026},
month = oct,
doi = {10.1080/22423982.2026.2735570},
url = {https://europepmc.org/article/MED/42919456},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Surgical delay is not associated with increased mortality in Greenlandic hip fracture patients: a 5-year retrospective cohort study.
AU - Elisabeth Charlotte Hansen
AU - Steen-Erik Christensen
AU - Frank Damborg
AU - Ane Simony
AU - Stig Andersen
PY - 2026
DA - 2026/10/22
JO - International journal of circumpolar health
DO - 10.1080/22423982.2026.2735570
UR - https://europepmc.org/article/MED/42919456
AB - Hip fractures are associated with increased morbidity and mortality. Guidelines recommend surgery within 24 h, but Greenland's vast geography and Arctic weather often delay surgical treatment. Our aims were (1) to describe the time until surgery among hip fracture patients in Greenland and (2) to evaluate its association with 30-day and 1-year mortality. All patients with hip fracture ICD-10 codes DS720, DS721 and DS722 from 2018 through 2022 were included. Data on time of diagnosis, time to operation, reason for delay, ASA score, Charlson Comorbidity Index (CCI), and time of death were collected from patient records. Crude and adjusted analyses were performed. Among 262 patients, the mean time to surgery was 91.4 h, and more than 24 h delay occurred in 90% of them. Mortality did not increase with surgical delay (30 days, OR = 1.0, 95% CI 0.8-1.1; 1 year, OR = 0.9, 0.8-1.1). Mortality rates were comparable to a parallel Danish cohort (30-day mortality of 9.9% vs 10.8% and 1-year mortality of 29.4% vs 28%), with distinctly shorter delays. Mortality was raised with a worse ASA score 3 (OR = 3.8, 1.9-7.4; p < 0.001) and CCI (OR = 3.1, 1.6-5.9; p = 0.001), and with age >70 years (OR = 2.5, 95% CI 1.1-5.9; p = 0.032). The constraint of vast distances and harsh weather in the Arctic causes long surgical delays in hip fracture patients, yet the inability to meet the surgical timeline recommended did not adversely affect mortality in hip fracture patients in Greenland. This questions a general need for fast-track surgery in resource-limited areas.
SN - 1239-9736
SN - 2242-3982
ER -