HIP FRACTURE SURGERY FOR GERIATRIC POPULATION-ONE YEAR BOSNIAN UNIVERSITY CENTER EXPIRIANCE
Background and Goal of Study: Hip fractures is one of the most common injury in geriatric population. These elderly population often have many other medical problems associated with ageing, which places them at high risk of mortality after anesthesia. Annualy in Europe, hip fracture affects about 628000 patients, accounting for 200000 deaths(1). More than tree-quarters of the patients are older than 65 years(1). Goals of our retrospective analysis is to evaluate current perioperative outcome for hip surgery patients 65 years or older, in our tertiary hospital center.  

Materials and Methods: Retrospective data were colected from electronical medical records of ours patients with hip fractures treated in our hospital in period from december 2016 to december 2017. In these period it was 431 patient for hip surgery. Analisis included 303 patients, age 65 years or older. Results and statistics was performed by SOFA statistic(1.4.6)   

Results and Discussion:Of 303 patients, mean age 78. GA recived n=99(32,71%)patients and n=204(67,3%) recived RA(spinal anesthesia). Surgery was performed after admission to hospital in first 24h n=77; 48h n=95; 72h n=42; over 72h n=87. According to ANOVA statistics there were statistical significances(p<0,01) that early surgery means less hospital stay, earlier transfer in rehabilitation center. The mean lenght of stay was 7,67 days, in GA group 8,49 vs. 7,36 in RA group (p=0,02). 30 day mortality were n=31(10,3%)totaly, but there is no statistical significances by anaesthesia type(p=0,25). Mean age among dead patients was 82 years. According to anaesthesia group less mortality were in RA group(n=18, 8,9%) vs. (n=12, 12,5%) in GA group. Average doses of transfused red blood cells in GA group were 2,62 vs. 2,22 in RA group. 

Conclusion(s):Our analysis show that we use more RA for geriatric patients, older than 65 years for hip fracture surgery. In geriatric populations in our center with hip fracture, the use of RA compared with GA was not associated with lower mortality, but was assotiated with a shorter length of stay. Early surgery lead to early rehabilitation. 

References (optional):1.M.Coburn, R.Sanders, M.Neuman et al. We may have improved but must get better still, The never-ending story of the eldery with fractured neck of femur. Eur J Anaesthesiol 2017; 34:115-117

02 / Hip fracture surgery for geriatric population-one year Bosnian university center expiriance