Delay in Geriatric Hip Fracture Surgery: Retrospective Analysis of Factors Associated with Perioperative Anesthesiologic Management and Their Impact on 30-Day Mortality and Morbidity

Objective: Although surgical treatment of hip fracture provides favourable outcomes, comorbidities and preoperative optimization determine the recovery and rehabilitation period in elderly population.This study evaluated the role of anesthesiologic management for appropriate timing of surgery, and other patient-specific factors for surgical intervention.Methods: The study group comprised of 240 geriatric patients with acute hip fractures, who underwent surgery at an academic tertiary care unit.Preoperative, intraoperative and postoperative variables associated with anesthesiologic management were retrospectively evaluated.A 30-day mortality and morbidity were the primary and secondary outcomes.Results: The median time between the patient's admission to the hospital and the time of surgery was 1 day.Approximately 29% patients stayed in intensive care unit postoperatively.The median length of hospitalization was 5 days, while the 30-day mortality rate was 1.3%.The American Society of Anesthesiologists (ASA) physical status was identified as the most common factor that significantly affected the 30-day mortality.Conclusion: To date, no consensus has been reached on the appropriate delay period for surgery of acute hip fractures.Our study demonstrates that the main factors determining the patient prognosis are ASA physical status score, and the functional status of the patients.Therefore, perioperative anesthesiologic management should be prioritized to provide optimization of these patients.