EVALUATION OF FACTORS AFFECTING MORTALITY IN GERIATRIC HIP FRACTURE SURGERY: A RETROSPECTIVE STUDY

Abstract

Introduction: The primary aim of this study is to evaluate the effect of anesthesia methods on in-hospital, 30-day, and six-month mortality following geriatric hip fracture surgery. The secondary aim is to evaluate the effect of preoperative comorbidities on mortality. Method: This retrospective study included patients aged ≥75 years who had undergone femoral neck fracture surgery. Results: The data of 135 patients were analyzed. The postoperative stay in the intensive care unit of patients who were given general anesthesia (p < 0.05) was significantly longer. In the comparisons made according to survival, the exitus cases were found to have higher rates of renal disease and dementia. The variables found to be significantly different in the paired comparisons and determined to be a risk factor as a result of logistic regression analysis were applied with an receiver operating characteristic analysis, as a result of which a cutoff value of 6 in the modified Charlson comorbidity index score was found to be statistically significant area under curve = 0.727, p < 0.001, 95% CI: 0.644–0.800). The cutoff value for preoperative hemoglobin was determined to be 11.4 (Area under curve = 0.643, p = 0.005, 95% confidence interval: 0.556– 0.723). Conclusions: Ensuring the preoperative waiting time does not exceed 48 hours, optimizing the medical and hemodynamic status with a multidisciplinary approach, and determining the anesthesia method according to the clinical characteristics of each patient may contribute to reducing mortality rates. Keywords: Hip Fractures; Geriatrics; Anesthesia; Mortality.