Early Mortality After Hip Fracture - Is Type of Surgery Important?

Introduction: Hip fractures are associated with an in-hospital mortality rate of 7-14%, and a profound impairment of independence and quality of life. Current guidelines indicate that surgery for hip fracture should be performed within 24 h of injury. The main purpose of this study was to determine which factors affect in-hospital mortality and the potential role of the anesthetist in its prevention. Methods: A retrospective, observational study of all patients submitted to hip fracture surgery during one year was carried out. Data were collected from medical records and linear regressions and a multivariate analysis with SPSS version 23.0 was run. Results: A total of 372 patients with the diagnosis of hip fracture submitted to surgery were included in this study. No correlation between waiting time for surgery and in-hospital mortality was found. In multivariate analysis, only increased ASA score (p=0,018) and having a fracture treated with an arthroplasty procedure (p=0,028) were statistically significant predictors of postoperative mortality. Conclusion: In our study, the statistically significant predictors of postoperative mortality were an increased ASA score and type of surgery (arthroplasty procedure). The surgical approach should always be a multidisciplinary decision, involving the anesthesiology and the orthopedic teams, and based on patient’s clinical state and not only the type of fracture.