Background and Goal of Study:The effect of preoperative wait time on mortality is a long-standing subject of debate. The main purpose of this study was to determine whether a delay in surgery for hip fracture, as for other clinical factors, affects in-hospital mortality. 
Materials and Methods:We conducted a retrospective, observational study of all patients who underwent surgical treatment of a hip fracture during one year. Data was acquired from hospital records. Logistic analyses were runned using SPSS version 23.0 for a p <0,05 to statistically significant differences. 
Results and Discussion:A total of 372 patients were included in this study. The majority was female (n=290; 78%), and the median age was 81 years old [21;99]. Most were classified as ASA III (51%) and ASA II (40%). The type of fracture was classified as intracapsular fracture (n=126; 34%) or extracapsular fracture (n=246; 66%), and type of surgery was classified as internal fixation (n=303; 82%) or hip replacement (n=69; 18%). The mean wait time for surgery was 49 hours. Half of patients waited more than 48 hours for surgery, and 75% waited for more than 24hours for surgery. The mortality rate following surgery was 4,3% (n=16). Patients submitted to surgery within 24 hours had an in-hospital mortality rate of 5,4%, against a rate of 5,0% in those patients who experience a delay of more than 24 hours. This was not a statistically significant difference (p=0,869), as well as for those who were operated on within 12 hours (5,0%) against those who experience a delay of more than 12 hours (6,9%, p =0,649). In multivariate analysis, only increased ASA score (p=0,002) and having a fracture treated with an arthroplasty procedure (p=0,028) were statistically significant predictors of postoperative mortality. 
Conclusion(s): Despite we don't found any correlation between time for surgery and in-hospital mortality, our results demonstrate that more invasive surgery (hip replacement) was a strong independent factor for in-hospital mortality. Therefore, surgical approach should be a multidisciplinary decision, involving the anesthesiology and the orthopedic teams, and be grounded on patient’s clinical state, not only the type of fracture.

05 / Early mortality in hip fracture: what does it matters?