The effect of perioperative cardiac risk factors on postoperative outcomes in the elderly patients undergoing hip replacement surgery

Abstract

Purpose: Cardiac risk factors are among the most important determinants of postoperative outcomes in elderly surgical patients. This study aimed to determine the effect of perioperative cardiac risk factors on postoperative adverse outcomes in elderly patients undergoing total hip replacement surgery. Materials and Methods: Patients aged 65 and older who underwent total hip replacement surgery at Cukurova University Hospital between 2014 and 2019 were analyzed retrospectively. The primary outcome measures were postoperative adverse outcomes and mortality rate. Results: Two hundred twenty-three patients with total hip replacement surgery within five years of experience in our hospital were screened. 34.5% had postoperative cardiac, pulmonary, cerebral, and infectious morbidity and systemic inflammatory response syndrome, and the in-hospital mortality rate was 2.2%. On multivariate analysis, perioperative risk factors associated with postoperative adverse outcomes included American Society of Anesthesiologists (ASA) II physical status (aOR 5.63, 95% CI 1.75-18.11), preoperative poor functional capacity (aOR 9.50, 95% CI 3.14-28.79), traumatic fracture (aOR 2.75, 95% CI 1.22-6.24), preoperative anemia (aOR 2.15, 95% CI 1.05-4.37), and prolonged surgery (aOR 1.02, 95% CI 1.01-1.02). Conclusion: A significant relationship was determined between preoperative poor functional capacity, pre-existing anemia, traumatic hip fracture, ASA II physical status, prolonged case duration and the risk of postoperative complications in elderly patients undergoing total hip replacement surgery.