Hip surgery success partially predicted by number of other existing conditions

Apr 01, 2010

Hip fractures are the second leading cause of hospitalization of elderly patients. In many cases, a hip fracture is the first step in a complete decline in the patient's health, setting off a long list of potential complications. According to a new study published in the April 2010 issue of The Journal of Bone and Joint Surgery (JBJS), a person's pre-surgical health classification-as determined by the American Society of Anesthesiologists (ASA)-is a leading indicator as to how well the person will fare after surgery to repair the hip fracture.

The purpose of the study was to define the complications after hip fracture in a single and identify care practices that may lead to improved outcomes in elderly patients with hip fractures.

"We found that the return to the best quality of life after hip surgery is not determined by the type of operation but rather by the patient's pre-existing conditions and complications after surgery," stated Derek Donegan, MD, study co-author and orthopaedic surgery resident at the Hospital of the University of Pennsylvania in Philadelphia. "It is also important to note that the patient's recovery was improved by a team approach of medical specialists, including geriatricians and physiatrists."

The ASA classification system represents the anesthesiologist's assessment of the general health and well-being of the patient before surgery. Typically, there are five classes:

  1. normal healthy patient
  2. patient with mild systemic disease
  3. patient with serious, non-incapacitating systemic disease
  4. patient with life-threatening incapacitating systemic disease
  5. patient that is near death.
The study consisted of a record review of 197 patients over age 65 who underwent surgery from 2004 to 2008 treated by the Hospital of the University of Pennsylvania and Fracture Service.

The study revealed:

  • Medical complications were more common in patients in ASA class 3 and class 4 than in those in class 2.
  • Patients in ASA class 3 had a 3.78 times greater chance of having a medical complication following surgery than those in class 2.
  • Patients in ASA class 4 had a 7.39 times greater chance of having medical complications following surgery than those in class 2.
  • No significant relationship was identified between the ASA class and surgical complications.
"We confirmed use of the ASA classification can help identify high-risk patients," continued Dr. Donegan. "We recommend these higher risk , in class 3 or 4, be closely managed medically so that any existing conditions can be treated and any evolving medical issues can be addressed in a timely manner," continued Dr. Donegan.

Dr. Donegan added, "Utilizing strategies that improve bone health and prevent hip fractures are ways to limit the significant impact a fall can have."

Explore further: Preservation technique for marginal livers prevents biliary stricture

add to favorites email to friend print save as pdf

Related Stories

How health care is paid for appears to impact outcome

Feb 25, 2010

Whether an individual is treated for a hip fracture at a hospital reimbursed by Medicare or is treated at a Department of Veterans Affairs Medical Center makes a significant difference in what happens to the patient after ...

Hip resurfacing is not for everyone

Nov 03, 2008

Hip resurfacing is often seen as a modern alternative to the more conventional total hip replacement, but new data from a study led by Rush University Medical Center suggest that a patient's age and gender are key to the ...

Recommended for you

New MCAT shifts focus, will include humanities

Oct 20, 2014

(HealthDay)—The Medical College Admission Test (MCAT) has been revised, and the latest changes, including more humanities such as social sciences, are due to be implemented next April, according to a report ...

Using feminist theory to understand male rape

Oct 20, 2014

Decades of feminist research have framed rape and sexual assault as a 'women's issue', leaving little room for the experiences of male victims. But a new study published in the Journal of Gender Studies suggests that feminist ...

User comments : 0