Outcomes of Hip Fracture Surgery in Elderly Patients with High American Society of Anesthesiologists Physical Status: a Comparison of Surgery Within 72 Hours Versus After 72 Hours
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Abstract
Background: Expedited hip fracture surgery in elderly patients can reduce complications and 1-year mortality. However, there is limited research on the clinical outcomes of expedited surgery in patients with high American Society of Anesthesiologists (ASA) physical status (classes III-IV).
Objective: To evaluate the outcomes of expedited surgery within 72 hours in terms of length of hospital stay, complications, and mortality in elderly hip fracture patients with high ASA physical status, compared to surgeries performed after 72 hours.
Material and methods: A retrospective cohort study was conducted among ASA class III-IV patients aged 60 years and above, who underwent hip fracture surgery at Chiang Rai Prachanukroh Hospital from October 2019 to September 2021. Data were compared between the group that underwent surgery within 72 hours (expedited group) and the group that underwent surgery after 72 hours (delayed group) in terms of length of hospital stay, 30-day post-operative complications and mortality, and 1-year mortality.
Results: A total of 345 patients were enrolled in the study, with a mean age of 77.4±8.1 years. Most of the patients were female (248 cases, 71.9%), had extra-articular fractures (241 cases, 69.9%), and were treated with internal fixation (227 cases, 65.8%). There were 198 patients (57.4%) in the expedited group with an average waiting time of 38±17 hours, and 147 patients (42.6%) in the delayed group with an average waiting time of 159±69 hours. Complications were found in 32 cases (16.2%) in the expedited group and 20 cases (13.6%) in the delayed group. The most common complication was a urinary tract infection. The 30-day mortality rate was 1.7% (6 cases), all due to pneumonia. The 1-year mortality rate was 3.8% (13 cases). There were no significant differences between the two groups in terms of complications, readmission rate, and mortality rate. However, expedited surgery significantly reduced the length of hospital stay (p<0.001).
Conclusion: Expediting surgery in elderly patients with high ASA physical status significantly reduced hospitalization time, without significant differences in complication, re-admission, and mortality rates
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บทความที่ส่งมาลงพิมพ์ต้องไม่เคยพิมพ์หรือกำลังได้รับการพิจารณาตีพิมพ์ในวารสารอื่น เนื้อหาในบทความต้องเป็นผลงานของผู้นิพนธ์เอง ไม่ได้ลอกเลียนหรือตัดทอนจากบทความอื่น โดยไม่ได้รับอนุญาตหรือไม่ได้อ้างอิงอย่างเหมาะสม การแก้ไขหรือให้ข้อมูลเพิ่มเติมแก่กองบรรณาธิการ จะต้องเสร็จสิ้นเป็นที่เรียบร้อยก่อนจะได้รับพิจารณาตีพิมพ์ และบทความที่ตีพิมพ์แล้วเป็นสมบัติ ของลำปางเวชสาร
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