Abstract
Background: Hip fractures are common in the elderly population accounting for 20–30% of acute trauma admissions and usually requiring operative treatment. With increasing age the risk of comorbidity increases reflected in higher ASA grades.
Aim: The aim of this study was to evaluate the correlation between ASA grading, morbidity, mortality and functional outcome within one- year from surgery in patients admitted with hip fractures.
Design: A retrospective study in a District General Hospital.
Methods: 155 patients with a mean age 83 years (60 to 102 years) were admitted with hip fractures between June 2001 to May 2002. There were 126 females 29 males. They were assessed for ASA grade, comorbidities, mental test score(MTS), complications and mortality at one year post admission.
Results: ASA 1: 15 patients mean age 79 years – MTS of 8.3, had no postoperative complications, and no mortality in this group.
ASA 2: 66 patients mean age 82 years – MTS 6.3, comorbities 1.8, average time to theatre 36 hours. 15% had injury/implant related complications, one year mortality rate was 4.5%.
ASA 3: 64 patients mean age of 84 years – MTS 3.9, comorbidities 2.7, average time to theatre of 3 days. 6.25% had injury specific complications, one- year mortality rate was 28.13%.
ASA grade 4: 6 Patients mean age 83 years – MTS 5, comorbidities 3. The one-year mortality rate was 83.33%.
Four patients were medically unfit to undergo any form of surgical intervention.
Overall 9% of patients had complications related to the injury/implant that occurred exclusively in ASA 2 and 3 groups and the one year mortality rate was 17.22% for the entire group.
Conclusions: The higher ASA grade in patients admitted with hip fractures results in increased postoperative mortality and morbidity. Despite recent advances in the standards of health care, the comorbid conditions in this aged population will place an ever increasing burden on the health services in the near future.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
