Abstract

Hip fractures are the second cause of hospitalization in geriatric patients. The American Society of Anesthesiologists (ASA) classification scheme is a scoring system for the evaluation of the patients' health and comorbidities before an operative procedure. The purpose of this study was to determine whether the ASA score is a predictive factor for perioperative and postoperative complications and a cause of readmission of geriatric patients with hip fractures. The study included 198 elderly patients. The mean values of hospitalization were 6.4 ± 2.1 days for the patients with ASA II, 10.4 ± 3.4 days for the patients with ASA III, and 13.5 ± 4.4 days for the patients with ASA IV. The patients with ASA II exhibited minor complications, while patients with ASA III presented cutaneous ulcer and respiratory dysfunction. Five patients with ASA IV had pulmonary embolism, two patients had myocardial infarction, and three patients died. The ASA score seems to have direct correlation with multiple factors, such as the hospitalization days, the severity of the complications, and the total hospitalization costs. The treatment of geriatrics hip fractures in patients with a high ASA score requires a multidisciplinary approach and a special assessment in order to decrease postoperative morbidity and mortality and offer optimal functionality.

Highlights

  • Hip fractures are a common and serious injury in elderly patients and they constitute the second cause of hospitalization [1]

  • The American Society of Anesthesiologists (ASA) score was statistically significantly higher for men compared with women (p = 0.019, confidence interval (CI) 95%, –0.44, and –0.03)

  • A statistically significant difference appears in the waiting time among patients with ASA II (p < 0.001, CI 95%, –2.05, and –4.32) and patients with ASA III (p < 0.001, CI 95%, –3.66, and –3.90) compared with the patients with ASA IV

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Summary

Introduction

Hip fractures are a common and serious injury in elderly patients and they constitute the second cause of hospitalization [1]. Hip fractures are linked to the high cost that is associated with the care of these patients and burdens on the health care systems [2]. The main treatment goal for these injuries is early mobilization in order to prevent complications that are associated with prolonged immobilization. Another important goal is the return to prefracture functional activity, which can be achieved with surgery. The mortality rates of geriatric hip fractures in one year vary from 18% to 33% [4] This demonstrates the need to determine and restrict the major postoperative complications that lead to these high rates of mortality

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