Korean J Anesthesiol.  2015 Dec;68(6):561-567. 10.4097/kjae.2015.68.6.561.

Risk factors associated with outcomes of hip fracture surgery in elderly patients

• Kim BH
• Lee S
• Yoo B
• Lee WY
• Lim Y
• Kim MC
• Yon JH
• Kim KM

• KMID: 2237306
• DOI: http://doi.org/10.4097/kjae.2015.68.6.561

Abstract

BACKGROUND
Hip fracture surgery on elderly patients is associated with a high incidence of morbidity and mortality. The aim of this study is to identify the risk factors related to the postoperative mortality and complications following hip fracture surgery on elderly patients.
METHODS
In this retrospective study, the medical records of elderly patients (aged 65 years or older) who underwent hip fracture surgery from January 2011 to June 2014 were reviewed. A total of 464 patients were involved. Demographic data of the patients, American Society of Anesthesiologists physical status, preoperative comorbidities, type and duration of anesthesia and type of surgery were collected. Factors related to postoperative mortality and complications; as well as to intensive care unit admission were analyzed using logistic regression.
RESULTS
The incidence of postoperative mortality, cardiovascular complications, respiratory complications and intensive care unit (ICU) admission were 1.7, 4.7, 19.6 and 7.1%, respectively. Postoperative mortality was associated with preoperative respiratory comorbidities, postoperative cardiovascular complications (P < 0.05). Postoperative cardiovascular complications were related to frequent intraoperative hypotension (P <0.05). Postoperative respiratory complications were related to age, preoperative renal failure, neurological comorbidities, and bedridden state (P < 0.05). ICU admission was associated with the time from injury to operation, preoperative neurological comorbidities and frequent intraoperative hypotension (P < 0.05).
CONCLUSIONS
Adequate treatment of respiratory comorbidities and prevention of cardiovascular complications might be the critical factors in reducing postoperative mortality in elderly patients undergoing hip fracture surgery.

Keyword

Aged; Complications; Hip fractures; Intensive care units; Length of stay; Mortality

MeSH Terms

Aged*
Anesthesia
Comorbidity
Hip Fractures
Hip*
Humans
Hypotension
Incidence
Intensive Care Units
Length of Stay
Logistic Models
Medical Records
Mortality
Renal Insufficiency
Retrospective Studies
Risk Factors*