Citation

Tekir Yılmaz E, Şahin Y, Olgun Keleş B, Altınbaş A. Ulus. Travma Acil Cerrahi Derg. 2024; 30(8): 571-578.

Copyright

(Copyright © 2024, Ulusal Travma ve Acil Cerrahi Dernegi)

DOI

10.14744/tjtes.2024.24186

PMID

39092971

Abstract

BACKGROUND: Various factors contribute to the development of mortality and morbidity in hip fracture surgeries. This study aims to investigate the effects of modifiable factors such as the type of anesthesia, anesthesia management, surgical method, and timing of surgery on 30-day mortality rates, intensive care unit admissions, and complications.

METHODS: A total of 400 patients who underwent hip fracture surgery between January 2021 and December 2023 at a Training and Research Hospital were retrospectively analyzed. Patients were divided into two groups: those followed in the ward, named Group 1 (n=304), and those in the intensive care unit, named Group 2 (n=96). Recorded data included demographic characteristics, American Society of Anesthesiologists (ASA) physical status scores, types of comorbidities, anesthesia type, surgical method, surgical delay time, duration of surgery, blood transfusion requirements, and complications.

RESULTS: Patients in Group 2 had higher mean age, comorbidity, and mortality rates compared to Group 1 (p<0.001). In terms of types of comorbidities, the rate of intensive care unit admission was higher in patients with coronary artery disease and chronic renal failure (p<0.001). Mean surgical delay and length of hospital stay were also higher in Group 2 (p<0.001). In multivariate logistic regression analysis, age (p<0.001, Odds Ratio [OR]=1.91, Confidence Interval [CI]=1.046-1.137), ASA score (p<0.001, OR=3.872, CI=1.913-7.838), duration of surgical delay (p<0.001, OR=2.029, CI=1.365-3.017), surgical method (p=0.003, OR=2.003, C=1.258-3.188), and length of hospital stay (p=0.006, OR=1.147, CI=1.04-1.266) were determined as predictive factors for 30-day mortality.

CONCLUSION: This study found that age, ASA classification, length of hospital stay, surgical method, and surgical delay were predictive factors for both morbidity and mortality. Among these, surgical delay time appears to be a modifiable parameter when all factors are considered.

Language: en

Keywords

Humans; Risk Factors; Aged; Female; Male; Middle Aged; Retrospective Studies; Aged, 80 and over; Comorbidity; Hospital Mortality; Turkey/epidemiology; *Hip Fractures/surgery/mortality; *Intensive Care Units/statistics & numerical data; Length of Stay/statistics & numerical data; Postoperative Complications/epidemiology/mortality; Time-to-Treatment/statistics & numerical data