Hip fracture surgery: Is the pre-operative American Society of Anesthesiologists (ASA) score a predictor of functional outcome?

Michel, Jean‐Pierre; Klopfenstein, Claude-Eric; Hoffmeyer, Pierre; Stern, Richard; Grab, B.

doi:10.1007/bf03324467

Cited by 95 publications

(70 citation statements)

References 18 publications

(20 reference statements)

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“…Although controversial (2), it has been advocated that male sex is related to increased mortality, even when other potential confounders are controlled for (21). Moreover, the literature supports the current findings that increased age (2), high ASA score (22), and delayed surgery (23) are correlated with increased mortality (Table 1). In this study, there were no significant differences in the mortality and complication rates between the unipolar and bipolar prosthesis groups.…”

Section: Discussionsupporting

confidence: 77%

Bipolar or Unipolar Hemiarthroplasty after Femoral Neck Fracture in the Geriatric Population

Ayhan¹,

Kesmezacar²,

Karaman³

et al. 2013

Balkan Med J

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Background: The choice of prosthesis in hemiarthroplasty is controversial for geriatric patients after femoral neck fracture. We hypothesised that selection criteria for unipolar or bipolar prostheses could be constructed based on factors affecting mortality. Aims:The aims of this retrospective study were: (1) to determine the factors affecting mortality of femoral neck fracture patients ≥65 years of age; (2) to compare patient mortality rates, radiological findings, and functional outcomes according to prosthesis type (unipolar or bipolar); and (3) to evaluate the persistence of inner bearing mobility of bipolar prostheses.Study Design: Retrospective comparative study. Methods:In total, 144 patients operated for hemiarthroplasty and aged ≥65 were included. We classified the patients into either unipolar or bipolar prosthesis groups. To reveal factors that affected mortality, age, sex, delay in surgery, and American Society of Anesthesiologists score were obtained from folders. Barthel Daily Living, Harris hip, and acetabular erosion scores were calculated and bipolar head movement was analysed for live patients.Results: One-year mortality was 31.94%. Age ≥75 (p=0.029), male sex (p=0.048), and delay in surgery ≥6 (p=0.004) were the patient characteristics that were related to increased mortality. There were no significant differences in sex, age, American Society of Anesthesiologists score, delay in surgery, mortality, or Barthel, Harris, acetabulum scores between the two groups. Twenty patients from each group were admitted for last follow-up. Bipolar head movement was preserved for 33.3% of patients. They were inactive patients with low Barthel and Harris scores. Conclusion:Although bipolar head movement was preserved in inactive patients, we suppose that this conferred no advantage to these patients, who could hardly walk. In this study, male patients, those aged ≥75 years, and those operated at ≥6 days had an increased risk of mortality. Also, although not significant in multivariate analysis, high American Society of Anesthesiologists score (≥3) was related to increased mortality. Considering that one of three patients died during the first postoperative year, we think that these patients should be operated as soon as possible, and expensive bipolar prostheses must be used selectively in regard to patient characteristics.

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Section: Discussionsupporting

confidence: 77%

Bipolar or Unipolar Hemiarthroplasty after Femoral Neck Fracture in the Geriatric Population

Ayhan¹,

Kesmezacar²,

Karaman³

et al. 2013

Balkan Med J

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“…The mean age of patients undergoing total hip replacement due to hip osteoarthritis was 74 year and due to hip fracture was 75 years, which is consistent with other studies of quality of life in patients with osteoarthritis (OA), where the population is over 60 years [13][14][15][16]. However, the mean age of patients is slightly higher in our study because of the fact that the sample was limited to patients older than 64 years (inclusion criterion), so the mean age is higher compared to the published literature.…”

Section: Discussionsupporting

confidence: 86%

Comparative of Infection Rate in Non-Elective and Elective Surgery, and Its Relation on Quality of Life

Tomás¹

2017

MOJOR

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Objectives: To study infection rates in patients undergoing total hip arthroplasty, comparing elective surgery against intervention due to hip fracture (nonelective), and being related to the quality of life of them, comparing infection sample versus uninfected one.Methods: Longitudinal prospective study of 104 patients older than 65 years who underwent hip replacement between October 2008 and March 2010, in "Consorcio Hospital General Universitario de Valencia". The EuroQol-5D was used for clinical assessment. Results:The infection rate was 2.88% at 6 months follow-up (3 elective surgery infections and no one infection in hip fracture), decreasing the prevalent infection rate to 0% at 12 months. Total hip arthroplasty intervention means an increase quality of life of 0.452 in the patients studied. Conclusion

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“…This might have been attributable to exclusion of people younger than 65 years and the relatively short followup in our study. We found the type and side of fractures did not affect mortality, although other studies suggested intracapsular [28] or extracapsular fractures [29] increased mortality. Gender, ASA rating, number of comorbidities, prefracture ambulatory status, and cognitive ability showed an effect on mortality in the preliminary analysis, but cognitive ability disappeared in multivariate logistic regression.…”

Section: Discussioncontrasting

confidence: 66%

“…Various factors (eg, age [9,38], gender [10,13,38], ASA rating [9,17], dementia [4], and type of fracture [28,29]) reportedly affect ambulatory status and mortality of elderly patients with hip fractures, but little is known of any differences in general characteristics between patients with and without hemiplegia who had hip fractures, factors predicting recovery of prefracture ambulatory status, and mortality of patients with hemiplegia after stroke who experienced hip fractures.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Prognosis for Elderly Patients with Poststroke Hemiplegia Experiencing Hip Fractures

Feng

Zhang

Shen

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Hip fracture surgery: Is the pre-operative American Society of Anesthesiologists (ASA) score a predictor of functional outcome?

Cited by 95 publications

References 18 publications

Bipolar or Unipolar Hemiarthroplasty after Femoral Neck Fracture in the Geriatric Population

Bipolar or Unipolar Hemiarthroplasty after Femoral Neck Fracture in the Geriatric Population

Comparative of Infection Rate in Non-Elective and Elective Surgery, and Its Relation on Quality of Life

Predictors of Prognosis for Elderly Patients with Poststroke Hemiplegia Experiencing Hip Fractures

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