The Effects of Comorbidities on Intensive Care Admission in Elderly Patients Undergoing Hip Surgerious

Introduction:We aimed to compare patients aged ≥75 in the intensive care unit with those in orthopedics clinic following hip replacement with respect to age, preoperative comorbidity, anesthesia types, length of hospital stay, and mortality. Materials and Methods:Patients aged ≥75 who underwent hip replacement at our hospital due to intertrochanteric femoral fracture in 2011-2016 were evaluated.Patients aged <75 with severe organ failure and hemorrhagic diathesis were excluded.Age, sex, comorbidity, anesthesia types, length of stay in the hospital before surgery and in the intensive care unit, and mortalities were evaluated in 130 patients.Patients were divided into two groups: patients in postoperative intensive care unit and those in postoperative orthopedic clinic.A p-value of <0.05 was considered statistically significant.Results: Mean age and the prevalence of hypertension, diabetes mellitus, congestive heart failure, and chronic obstructive pulmonary disease were significantly higher in patients in the intensive care unit than in those in postoperative orthopedic clinic.No difference was observed between the groups in anesthesia types.Length of hospital stay was significantly longer in patients in the intensive care unit.In logistic regression analysis, older age and presence of chronic obstructive pulmonary disease had significant effect on admission to the intensive care unit.Discussion: We believe that detailed preoperative evaluation, optimization of patient condition using current treatments when necessary, and postoperative intensive care unit monitoring are beneficial for patients with hip fracture aged ≥84 with comorbidities, such as hypertension, diabetes mellitus, congestive heart failure, and chronic obstructive pulmonary disease.