Is the ASA Score in Geriatric Hip Fractures a Predictive Factor for Complications and Readmission?

Abstract

Hip fractures are the second cause of hospitalization in geriatric patients and the treatment cost increases annually. The American Society of Anesthesiologists (ASA) classification scheme was created to establish a scoring system for the evaluation of the patients’ health and comorbidities before an operative procedure. The purpose of this study was to determine whether the ASA score is a predictive factor for perioperative and postoperative complication sand a cause for readmission of geriatric patients with hip fractures.The study included 198 elderly patients. The age, the gender, the medical comorbidities, the ASA score, the type of operation, the perioperative and postoperative complications and the dates of admission, operation and hospital discharge were reviewed. Seventy-six cases were classified as ASA II, 91 cases were classified as ASA III and 31 cases were classified as ASA IV. The average waiting time for surgery was 2.3±1.2 days for the patients with ASA II, 5.2±1.1 days for the patients with ASA III and 8.4±2.9 days for the patients with ASA IV. The mean values of the days of hospitalization were 6.4±2.1, 10.4±3.4 and 13.5±4.4 respectively. The patients with ASA II exhibited minor complications, while patients with ASA III presented cutaneous ulcer and respiratory dysfunction. Moreover, five patients with ASA IV had pulmonary embolism, two patients had myocardial infarction and three patients died. The ASA score seems to have direct correlation with multiple factors, such as the days of hospitalization, the severity of the complications and the total hospitalization costs. The treatment of geriatrics hip fractures in patients with a high ASA score requires a multidisciplinary approach and a special assessment in order to decreasepostoperative morbidity and mortality and offer optimal functionality.