Balancing risks in febrile hip fracture patients: is surgical delay more dangerous than infection?
Authors' conclusion
Early surgery in febrile hip fracture patients may be safe when guided by individualized assessment. Our findings support developing structured clinical criteria to aid surgical timing decisions, warranting further validation through larger prospective studies.
Study context
- Population
- Patients with low-energy hip fractures and documented preoperative fever (T > 38 °C), tertiary trauma center, 2012–2023; median age 83 years, 58% women
- Participants
- 208 patients
- Exposure
- Early vs delayed hip fracture surgery in febrile patients
- Earlyn = 108
- Delayedn = 100reference
- Outcome
- All-cause mortality, from the national registry
- Follow-up
- One year
Methodological detailssingle tertiary trauma center
- Single tertiary trauma center
Main finding
As reported in the abstract
One-year all-cause mortality
P = 0.079
Observational data: associations, not effects.
Secondary outcomes
Postoperative LOS · shorter after early surgery
P = 0.031
Baseline differences in patients selected for early surgery
- Early surgery patients had fewer systemic signs of illness, including lower CRP levels, less desaturation and less frequent bacterial infections
Deep surgical site infection and one-year mortality in patients with confirmed bacterial etiology
- Early surgery did not increase deep surgical site infection rates or one-year mortality vs delayed surgery
Safety
Deep surgical site infection requiring surgical intervention
P = 0.148
Original publication
Balancing risks in febrile hip fracture patients: is surgical delay more dangerous than infection? Osteoporos Int. Published 16 February 2026. doi:10.
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