Delayed surgery
Delayed surgery has been studied in 29 papers since 2021: 1 trial and 26 observational studies in people, 2 reviews; 4 in the past year. The newest paper, Mar 5, 2026: “Small bowel obstruction and frailty: a systematic review”.
29 papers study it38 findingsUpdated
“Multivariable logistic regression models showed that the odds of mortality in the delayed group was 14% higher than that in the reference group (adjusted odds ratio [aOR], 1.14; p = 0.002)”
3 of its findings point the other way.
- 25 independent labs in 15 countries
- 3 findings against
- Funders: Dalhousie Medical Research Foundation and 3 more
- Human trial1
- Humans26
What did studies of Delayed surgery find?
8Studies of Delayed surgery measured 8 outcomes; the most studied are mortality (3 studies), length of stay (2) and hip-related complications (1).
Mortality
upin humans2no changein humans1
3 studies
Mortality
upin humans2no changein humans1
Delayed surgery increases mortality in humans.
“A longer interval between injury and surgery was associated with higher mortality.”
Humanship fracture surgeryone yearn = 667
Journal of clinical orthopaedics and trauma
Delayed surgery increases mortality in humans.
“A surgical delay of over 100 h and a lack of geriatric co-management were related to in-hospital mortality and medical complications.”
Humansperiprosthetic fracturesn = 1,387
Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology
Delayed surgery has no effect on mortality in humans.
“Delayed surgery after 48 h did not negatively influence mortality after PFF.”
Humansafter periprosthetic femoral fracture
Journal of clinical medicine
Length of stay
upin humans2
2 studies
Length of stay
upin humans2
Delayed surgery increases length of stay in humans (7.96 vs 5.73 days, p<0.001).
“Surgery performed more than 48 hours after arrival prolonged hospital stay (7.96 vs. 5.73 days for <24 hours, p<0.001).”
Humansin geriatric hip fracture patientsn = 412
Hip Fracture Patterns Among Hispanic Seniors: Risk Factors and Implications
Cureus
Delayed surgery increases length of stay in humans (10.7 days vs. 6.9 days, p < 0.001).
“and had longer length of stay (10.7 days vs. 6.9 days, p < 0.001).”
Humanship fracture
Injury
Hip-related complications
no changein humans1
1 study
Hip-related complications
no changein humans1
Delayed surgery has no effect on hip-related complications in humans.
“no difference was observed in hip-related complications.”
Humans
Hip Fractures in Malta: Does Delay in Surgery Affect Clinical Outcomes?
Cureus
Length of hospital stay
upin humans1
1 study
Length of hospital stay
upin humans1
Delayed surgery increases length of hospital stay in humans.
“A delay of more than 36 hours to surgery was associated with a statistically significant increase in both length of hospital stay”
Humans
Hip Fractures in Malta: Does Delay in Surgery Affect Clinical Outcomes?
Cureus
Postoperative mobilization
downin humans1
1 study
Postoperative mobilization
downin humans1
Delayed surgery impairs postoperative mobilization in humans (63 % vs. 67.4 %, p < 0.001).
“less likely to achieve postoperative mobilization within 24 h (63 % vs. 67.4 %, p < 0.001)”
Humanship fracture
Injury
Length of stay in acute care
upin humans1OR 3.79
1 study
Length of stay in acute care
upin humans1OR 3.79
Delayed surgery increases length of stay in acute care in humans (OR 3.79, 95% CI 2.05-7.15).
“those who had surgery beyond this time frame had a significantly longer stay in acute care (OR: 3.79, 95% CI: 2.05-7.15)”
Humanship fracture
Health Outcomes of Older Adults after a Hospitalization for a Hip Fracture
Canadian geriatrics journal : CGJ
Physical function
downin humans1
1 study
Physical function
downin humans1
Delayed surgery impairs physical function in humans.
“Group B had lengthier hospital stays, poorer mobility, and higher physical and mental difficulties.”
Humansproximal femoral fractures after a trivial falln = 101
European journal of orthopaedic surgery & traumatology : orthopedie traumatologie
Ambulation
downin humans1
1 study
Ambulation
downin humans1
Delayed surgery impairs ambulation in humans (36% vs. 16% non-ambulatory, p<0.001).
“reduced ambulation at 3 months (36% vs. 16% non-ambulatory, p<0.001).”
Humanship fractures3 monthsn = 236
Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH
What is Delayed surgery linked with?
12Studies link Delayed surgery with 12 measures, most often mortality (15 studies), one-year mortality (2) and hospital readmission (1).
Mortality
upin humans15+8.8% odds of mortality per day of delayHR 1.03–1.35
15 studies
Mortality
upin humans15+8.8% odds of mortality per day of delayHR 1.03–1.35
Delayed surgery raises the risk of mortality in humans.
“The largest study (≈50,000 patients) demonstrated that delayed intervention increased 30-day mortality, independent of confounders.”
Reviewsmall bowel obstructionn = 50,000
Small bowel obstruction and frailty: a systematic review
European geriatric medicine
Delayed surgery is associated with mortality in humans.
“Independent predictors of mortality were delayed surgery, higher Charlson Comorbidity Index, and low Geriatric Nutritional Risk Index.”
Humanship fracture surgeryn = 355
Journal of clinical medicine
Delayed surgery is associated with mortality in humans (HR 1.03, 95% CI 1.00-1.06, P = 0.0399).
“Each 1-day delay in ATO was associated with a 3% increase in the long-term mortality rate (HR = 1.03; 95%CI: 1.00-1.06; P = 0.0399).”
Humanship fractureseach 1-day delayn = 1,366
European journal of trauma and emergency surgery : official publication of the European Trauma Society
Delayed surgery raises the risk of mortality in humans (adjusted HR 1.15, 95% CI 1.02–1.30, P = .02).
“each additional day of delay in surgery was associated with an increased risk of mortality, with adjusted hazard ratios (HR) of 1.15 (95% CI [1.02, 1.30], P = .02)”
Humanship fracture repairn = 967
Geriatric orthopaedic surgery & rehabilitation
Delayed surgery raises the risk of mortality in humans (+26.7% odds per day).
“In operatively managed adults, each day of delayed surgery raised mortality odds by 26.7%”
Humansoperatively managed adult intussusception patients
Langenbeck's archives of surgery
Delayed surgery raises the risk of mortality in humans.
“A delay of more than 36 hours to surgery was associated with a statistically significant increase in both length of hospital stay and mortality at one and three years”
Humans3 years
Hip Fractures in Malta: Does Delay in Surgery Affect Clinical Outcomes?
Cureus
Delayed surgery raises the risk of mortality in humans (OR 2.80, 95% CI 1.13-7.38).
“Time to surgery beyond 24 hours (OR: 2.80, 95% CI: 1.13-7.38) was associated with a higher likelihood of death 30 days post-discharge.”
Humanship fracture30 days post-discharge
Health Outcomes of Older Adults after a Hospitalization for a Hip Fracture
Canadian geriatrics journal : CGJ
Delayed surgery raises the risk of mortality in humans.
“In elderly nonfrail patients, a higher mortality was observed when surgery was postponed after 2 days.”
Humansin elderly nonfrail patients with small bowel obstruction>2 days
Timing to surgery in elderly patients with small bowel obstruction: An insight on frailty
The journal of trauma and acute care surgery
Delayed surgery raises the risk of mortality in humans.
“A delay in surgery was associated with an increased risk of in-hospital mortality across all strata”
Humansisolated hip fracturen = 254,400
Prioritizing patients for hip fracture surgery: the role of frailty and cardiac risk
Frontiers in surgery
Delayed surgery raises the risk of mortality in humans (31% vs. 12%, p<0.001).
“Delayed patients (31.8%) exhibited significantly higher 1-year mortality (31% vs. 12%, p<0.001)”
Humanship fractures1 yearn = 236
Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH
All 15Fewer
One-year mortality
upin humans2
2 studies
One-year mortality
upin humans2
Delayed surgery is associated with one-year mortality in humans.
“Perioperative factors such as higher injury severity and delayed surgery, and post-discharge factors including hospital readmission, missed follow-up visits, and postoperative complications, were also associated with increased mortality.”
Reviewfollowing hip fracturen = 835,226
medRxivPreprint
Delayed surgery is associated with one-year mortality in humans (5.64 vs 4.50 days, P = 0,001).
“The mean surgery time was 5.64 days in patients with 1-year mortality; and 4.50 days in patients who lived longer than one year (P = 0,001).”
Humanship fracturen = 834
Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES
Hospital readmission
upin humans1OR 1.16
1 study
Hospital readmission
upin humans1OR 1.16
Delayed surgery raises the risk of hospital readmission in humans (adjusted OR 1.16, 95% CI 1.05–1.29).
“readmission within 30 days of discharge, with adjusted odds ratios (OR) of 2.26 (95% CI [1.89, 2.74]) and 1.16 (95% CI [1.05, 1.29]), respectively”
Humanship fracture repairn = 967
Geriatric orthopaedic surgery & rehabilitation
Prolonged length of stay
upin humans1OR 2.26
1 study
Prolonged length of stay
upin humans1OR 2.26
Delayed surgery raises the risk of prolonged length of stay in humans (adjusted OR 2.26, 95% CI 1.89–2.74).
“each additional day of delay was associated with an increased risk of a length of stay >7 days”
Humanship fracture repairn = 967
Geriatric orthopaedic surgery & rehabilitation
Wound infection
upin humans1
1 study
Wound infection
upin humans1
Delayed surgery is associated with wound infection in humans (p = 0.022).
“A delay of surgery beyond 24 h after admission was associated with the development of wound infections (p = 0.022)”
HumansPFF admission>24 hn = 1,217
Aging clinical and experimental research
Pressure ulcer
upin humans1
1 study
Pressure ulcer
upin humans1
Delayed surgery raises the risk of pressure ulcer in humans (10.7 % vs. 6.9 %, p < 0.001).
“Patients with delay of surgery more than 2 days rather than within 2 days were more likely to present an ASA score above 2 (58.9 % vs. 41.1 %, p < 0.001), less likely to achieve postoperative mobilization within 24 h (63 % vs. 67.4 %, p < 0.001), more likely to develop pressure ulcers (10.7 % vs. 6.9 %, p < 0.001)”
Humanship fracture
Injury
30-day mortality
upin humans1
1 study
30-day mortality
upin humans1
Delayed surgery raises the risk of 30-day mortality in humans (7.5 % vs. 5.4 %).
“There were higher statistically significant differences in 30-day mortality between patients who underwent surgery after 2 days (7.5 %) and those who underwent surgery within 2 days (5.4 %).”
Humanship fracture
Injury
Poor quality of life
upin humans1RR 1.97
1 study
Poor quality of life
upin humans1RR 1.97
Delayed surgery raises the risk of poor quality of life in humans (RR=1.97, 95% CI: 1.57-2.47).
“EQ-5D VAS<80: RR=1.97, 95% CI: 1.57-2.47”
Humanship fractures12 monthsn = 863
International journal of surgery (London, England)
Poor mobility
upin humans1RR 1.49
1 study
Poor mobility
upin humans1RR 1.49
Delayed surgery raises the risk of poor mobility in humans (RR=1.49, 95% CI: 1.13-2.01).
“PMS<7: RR=1.49, 95% CI: 1.13-2.01”
Humanship fractures12 monthsn = 863
International journal of surgery (London, England)
Poor hip function
upin humans1RR 1.56
1 study
Poor hip function
upin humans1RR 1.56
Delayed surgery raises the risk of poor hip function in humans (RR=1.56, 95% CI: 1.00-2.51).
“an increased risk was obtained from receiving surgery after 48 h and the poor functional outcomes (HHS<80: relative risk (RR)=1.56, 95% CI: 1.00-2.51”
Humanship fractures12 monthsn = 863
International journal of surgery (London, England)