O1493 RELATION BETWEEN HEALTH STATUS AND THE TIMING OF SURGERY ON MORTALITY IN HIP FRACTURE PATIENTS

Abstract

Aims: The purpose of the study was to determine the relationship of preoperative health status and surgery delay on postoperative complications and mortality in patients with hip fracture Methods: 195 patients with hip fracture were admitted to the Institute between 1997 and 2001. Information on the demographics, pre-existing medical conditions, type of fracture, operation and anesthesia, and postoperative complications during hospitalization was obtained from the medical records. Preoperative health status was assessed by the ASA classification. Medical records and the telephone interviews were used for follow-up on the patient’s vital status. Results: Analysis include patients who were 65 and older, cognitively intact, living at home and able to walk before surgery. 64% were female with femoral neck fracture. More than half had two or more pre-existing medical conditions and ASA grade III or IV. Follow-up period averaged 24 months (6 to 60). The overall mortality was 15% at one year, 23% at two years and 30% at three years. The three year mortality was less for ASA I and II patients than for ASA III, IV and V group. We found difference in mortality between patients having surgery within 24 hours of admission (25%) and those with operative delay beyond 24 hours of admission (45%). Conclusions: Operative treatment within 24 hours of admission showed lower mortality rate than in patients having surgery beyond 24 hours of admission in conjunction with preoperative ASA classification