The relationship between preoperative American Society of Anesthesiologists Physical Status Classification scores and functional recovery following hip-fracture surgery

Abstract

BackgroundLittle is known about the relationship of the American Society of Anesthesiologists Physical Status Classification scores (ASA scores) on patient outcomes following hip fracture surgery in Asian countries. Therefore, this study explored the association of patients’ preoperative ASA scores on trajectories of recovery in physical functioning and health outcomes during the first year following postoperative discharge for older adults with hip-fracture surgery in Taiwan.MethodsThe data for this study was generated from three prior studies. Participants (N = 226) were older hip-fracture patients from an observational study (n = 86) and two clinical trials (n = 61 and n = 79). Participants were recruited from the trauma wards of one medical center in northern Taiwan and data was collected prior to discharge and at 1, 3, 6, and 12 months after hospital discharge. Participants were grouped as ASA class 1–2 (50.5%; ASA Class 1, n = 7; ASA Class 2, n = 107) and ASA class 3 (49.5%, n = 112). Measures for mortality, service utilization, activities of daily living (ADL), measured by the Chinese Barthel Index, and health related quality of life, measured by Medical Outcomes Study Short Form-36, were assessed for the two groups. Generalized estimating equations (GEE) were used to analyze the changes over time for the two groups.ResultsDuring the first year following hip-fracture surgery, ASA class 1–2 participants had significantly fewer rehospitalizations (6%, p = .02) and better scores for mental health (mean = 70.29, standard deviation = 19.03) at 6- and 12-months following discharge than those classified as ASA 3. In addition, recovery of walking ability (70%, p = .001) and general health (adjusted mean = 58.31, p = .003) was also significantly better than ASA 3 participants.ConclusionsThere was a significant association of hip-fracture patients classified as ASA 1–2 with better recovery and service utilization during the first year following surgery. Interventions for hip fractured patients with high ASA scores should be developed to improve recovery and quality of life.

Influence of mobilization and weight bearing on in-hospital outcome in geriatric patients with hip fractures

“…In this context, a higher ASA-Score and a higher age were the only predictors for a lower ability to walk in our study population. This is consistent with other studies [13,14,23,32].…”

“…This is consistent with international studies which showed in-hospital mortality rates between 3 and 10% [13,16,28–31]. In addition, ASA score has been previously found to have an influence on mortality after a fracture of the hip [14,23,32]. In our cohort, a short time to first mobilization is associated with a lower mortality rate.…”

Femoral Stem Subsidence and its Associated Factors after Cementless Bipolar Hemiarthroplasty in Geriatric Patients

“…Bone condition changes associated with hyperglycemia or chronic renal disease could affect bone quality, delaying bone-ingrowth fixation at the bone-implant interface, the bone healing process, vascularisation, and subsequent mechanical stability 24 . In their study, Chen et al 22 found that a higher ASA score was associated with older patients that had low bone density (79.39 ±7.85 years old). Those results might explain our finding that the ASA score affected femoral stem subsidence.…”

“…The comorbidity assessment using ASA scores showed a correlation to various factors, including the length of stay, the severity of complications, and the treatment's total cost. A higher ASA score was associated with a higher risk of post-operative complications and mortality rates 15 , 22 . This study showed a significant relationship between ASA score 3 with the stem subsidence (p = 0.011, OR = 2.77).…”

Effect of different anaesthetic techniques on gene expression profiles in patients who underwent hip arthroplasty

“…The pain intensity level was evaluated by Numerical Rating Scale (NRS) values. The prediction of the operative risk has been evaluated by American Society of Anaesthesiologists (ASA) physical status classification [10].…”