Sheehan KJ, et al. – This review focused on the patients and system factors associated with time to surgery after hip fracture. In investigations, various patient and system factors associated with time to surgery were identified. These findings would aid in the evaluation of the putative timing–death association.

Methods

• The framework developed by Arksey and O’Malley and Levac was used for synthesis of factors and mechanisms of time to surgery after hip fracture in adults aged >50 years, published in English, between 1 January 2000 and 28 February 2017, and indexed in MEDLINE, EMBASE, CINAHL or Ageline.
• From discussion sections, proposed mechanisms for reported associations were extracted.

Results

• Evidence were accumulated from 26 articles that reported on 24 patient and system factors of time to surgery post hip fracture.
• In total, 16 factors were reported by only one article.
• For 16 factors, proposed mechanisms were found for their association with time to surgery which included surgical readiness, available resources, prioritisation and out–of–hours admission.