Τρίτη 10 Ιουλίου 2018

Geriatric patients with hip fracture: Frailty and other risk factors affecting the outcome

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Bindu K Vasu, Kruthika P Ramamurthi, Sunil Rajan, Mathew George

Anesthesia: Essays and Researches 2018 12(2):546-551

Background: Hip fracture is a devastating health-care problem in a geriatric patient, leading to high mortality and morbidity. Preoperative risk assessment in the geriatric patient is often inexact because of the difficulty in measuring their poor physiologic reserves. Aims: The primary objective was to find the association of modified frailty index (MFI) with 90-day mortality in geriatric patients who received anesthesia for fractured hip. Secondary objectives were to assess the association of preoperative waiting time with the 90-day mortality and the correlation of preexisting medical conditions with poor functional outcome among the survivors. Settings and Designs: This prospective, observational study was conducted at a tertiary care institution. Subjects and Methods: In this prospective observational study, done over a period of 1 year, 60 geriatric patients aged ≥65 years who received anesthesia for fractured hip and fulfilled selection criteria were recruited. The association of MFI with 90-day mortality and the correlation of preexisting comorbidities with poor functional outcome among the survivors were assessed. Statistical Analysis Used: Independent sample t-test, Mann–Whitney test, and odds ratio were used as applicable. Results: Total 60 patients were available for analysis as two patients dropped off from final 62 on follow up, fifty three patients survived after 90 days. MFI and 90-day mortality showed a significant direct correlation with P < 0.0001. However, no association was found between the preoperative waiting time and 90-day mortality. Preexisting medical conditions showed a significant association of dementia with total dependence afterward with a P = 0.02. Conclusion: There is significant statistical correlation of MFI with the 90-day mortality in the geriatric hip-fractured patients undergoing surgery.

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