The Effect of Postoperative Frailty on Morbidity and Mortality in Geriatric Hip Fracture Patients: Prospective Cohort Study.

PURPOSE: Hip fractures are a common health issue in geriatric patients, and their incidence increases with age. The aim of this study was to investigate the changes in frailty status of geriatric patients who underwent hip fracture surgery in the postoperative period, as well as to examine the effects of frailty on morbidity and mortality.

DESIGN

This study was designed as a prospective observational study.

METHODS

The study was conducted between January 2023 and May 2023 in the operating room of the Department of Orthopedics and Traumatology at Ege University Faculty of Medicine. A total of 101 patients who underwent surgery for hip fractures were included in the study. Data were collected using the Edmonton Frail Scale (EFS), Clinical Frailty Scale (CFS), Charlson Comorbidity Index (CCI), Mini-Mental State Examination (MMSE), and Barthel Index (BI). The data collection was conducted through face-to-face interviews.

FINDINGS: During the study period, a total of 101 patients, 68.3% female and 31.7% male, were evaluated. The average Charlson Comorbidity Index score was found to be 5 ± 2. According to the Mini-Mental State Examination, 28.7% had moderate impairment and 25.7% had severe impairment. The mean Barthel Index score on day 0 was determined as 85% ± 15%, and 18.8% of the patients were independent. When their status was re-evaluated at the third month, 14.9% were found to be independent and the average score was 78 ± 22. On postoperative day 0, the average Edmonton Frail Scale score was calculated as 7.3 ± 3, with 16.8% of the patients being severely frail. When evaluated at postoperative month 3, the average score was 7.7 ± 3.7, with 25.7% being severely frail. On postoperative day 0, the Clinical Frailty Scale indicated that 45.5% of the patients were frail, while at postoperative month 3, 37.6% were found to be frail. When contacted at the third postoperative month, 14.9% of the patients had passed away. Analyzing the relationship between mortality and the baseline values of the frailty scales and the baseline Mini-Mental State Examination score, those who had passed away were more frail and had lower scores on the Mini-Mental State Examination.

CONCLUSION

Given the increasing elderly population both globally and in our country, we believe that specialized approaches for the geriatric population will become increasingly important and that frailty should not be overlooked.