Department of Anaesthesiology and Reanimation, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey.
Agri. 2020 Apr;32(2):72-78. doi: 10.14744/agri.2019.56689.
Hip surgeries performed in elderly patients are important in terms of both the physiological features of geriatric patients and the risks of surgery. The aim of this study was to evaluate the effects of age and the anesthesia method used on morbidity and mortality in geriatric patients who had hip surgery.
Patients who were aged 65 and older who also had hip surgery and had American Society of Anesthesiologists (ASA) Physical Status Scale scores were included in the study. The patients were classified as aged (Group AG) for those ≥65 years of age, and very aged (Group VAG) for those ≥75 years of age. Details obtained from the hospital electronic records system of the patients' age, sex, ASA score, anesthesia method used, intraoperative and postoperative blood transfusion requirements, respiratory and cardiovascular complications, postoperative intensive care requirements, duration of hospital treatment, period of development of any postoperative complications, morbidity, and mortality were evaluated by age group.
A total of 258 patients between the ages of 65 and 95 who had hip surgery and available ASA scores were included in the study. In Group VAG, the rate of morbidity and mortality of ASA III and IV patients was high in the postoperative period. Regional anesthesia methods were used more often in Group VAG patients, and there were more cardiovascular complications developing in the intraoperative period in the general anesthesia patients, although there was no difference between anesthesia methods in terms of postoperative morbidity and mortality.
In this study of elderly patients who had hip surgery, there was no correlation between the anesthesia method used and morbidity and mortality. Advanced age (≥75 years) and a high ASA score were the most important risk factors for mortality.
老年患者的髋关节手术无论从老年患者的生理特点还是手术风险来看都非常重要。本研究旨在评估年龄和麻醉方法对行髋关节手术的老年患者发病率和死亡率的影响。
纳入年龄≥65 岁且美国麻醉医师协会（ASA）身体状况分级评分的髋关节手术患者。将患者分为年龄≥65 岁的 A 组（AG 组）和年龄≥75 岁的非常高龄组（VAG 组）。从医院电子病历系统中获取患者的年龄、性别、ASA 评分、麻醉方法、术中及术后输血需求、呼吸和心血管并发症、术后重症监护需求、住院时间、任何术后并发症的发展时间、发病率和死亡率等详细信息，并按年龄组进行评估。
共纳入 258 例年龄 65-95 岁且 ASA 评分可获得的髋关节手术患者。在 VAG 组中，ASA III 级和 IV 级患者在术后发病率和死亡率较高。VAG 组患者更多地采用区域麻醉方法，全麻患者术中更易发生心血管并发症，尽管在术后发病率和死亡率方面麻醉方法无差异。
在这项对行髋关节手术的老年患者的研究中，麻醉方法与发病率和死亡率之间无相关性。高龄（≥75 岁）和较高的 ASA 评分是死亡率的最重要危险因素。
