title: Preoperative indicators affecting postoperative mortality in elderly patients with hip fractures.
abstract: OBJECTIVE
  In this study, we aimed to evaluate the factors which affect postoperative mortality in elderly patients with hip fractures and the reliability of the American Society of Anesthesiologists (ASA) classification.
  
  
  METHODS
  The study included 107 patients (70 females, 37 males) of 65 years of age or older who were operated due to hip fracture. Preoperative laboratory and clinical data were collected from hospital files. Follow-up was conducted over the phone. The number of the patients who died in the first postoperative 12 months was compared with the official Turkish Statistical Institute mortality data. Preoperative clinical and laboratory findings and ASA scores were compared between surviving and deceased patients.
  
  
  RESULTS
  Twenty-eight patients died in the postoperative first year. The first year mortality rate was significantly higher than the normal population (p<0.05). Of these 28 patients, 16 died within the first 3 months; the majority due to respiratory insufficiency. The death ratio was significantly higher in patients with abnormal creatinine values (p=0.001) in the preoperative laboratory results and classified as ASA 4 (p<0.0001). Postoperative mobilization was slower and mortality was higher in patients with cognitive dysfunction, such as senile dementia.
  
  
  CONCLUSIONS
  The mortality rate in patients operated for hip fractures is higher when compared to the mortality rate in patients of the same age group. Because most deaths caused by pulmonary insufficiency occurred in the first 3 months in which patients were not adequately mobilized, the main cause of death might be pulmonary embolism. Abnormal creatinine values might indicate insufficient kidney function as another reason of death. ASA classification is useful for determination of preoperative risk in the elderly patients with hip fractures.
authors: Department of Orthopedics and Traumatology, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey.
authors: Hasan
authors: H
authors: Bombaci
authors: Özgür
authors: Ö
authors: Erdoğan
authors: Fatih
authors: F
authors: Çetinkaya
authors: Mehmet
authors: M
authors: Kuyumcu
authors: Emre
authors: E
authors: Kaya
authors: Elif
authors: E
authors: Bombaci
mesh_terms: D000368:Aged; D019072:Antibiotic Prophylaxis; D002423:Cause of Death; D005260:Female; D005265:Femoral Neck Fractures / Q000401:mortality* / Q000601:surgery*; D006620:Hip Fractures / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D008297:Male; D011184:Postoperative Period; D057234:Preoperative Period; D018570:Risk Assessment