Geriatric cognitive frailty and short-term prognosis following hip fracture surgery.

Abstract

Background: To evaluate the prevalence of cognitive frailty in geriatric patients with hip fractures and to assess its association with short-term postoperative complications following surgical intervention.

Methods: This single-centre observational study enrolled geriatric patients (aged ≥ 65 years) undergoing surgical intervention for hip fracture. Patients were stratified into cognitive frailty and non-cognitive frailty groups based on assessments using the FRAIL scale and the Montreal Cognitive Assessment (MoCA). Clinical outcomes, including duration of hospitalisation and postoperative complications (e.g., cardiovascular, pulmonary, cerebrovascular, gastrointestinal events, and delirium), were compared between the cohorts. Multivariable logistic regression analysis was employed to identify independent risk factors for postoperative complications.

Results: A total of 159 patients (mean age: 81.35 ± 8.44 years) were enrolled, of whom 28.3% were classified as having cognitive frailty. Compared to the non-frail group, the cognitive frailty group exhibited a significantly longer hospital stay (15.6 ± 3.3 days vs. 13.9 ± 2.7 days, P < 0.05) and a higher incidence of postoperative complications (24.4% vs. 8.8%, P = 0.011). Multivariate analysis identified cognitive frailty (OR = 2.73, 95% CI: 1.03-7.25) and the Charlson Comorbidity Index (CCI) (OR = 1.31, 95% CI: 1.01-1.70) as independent risk factors for postoperative complications.

Conclusion: Cognitive frailty is highly prevalent among elderly patients with hip fractures and represents an independent predictor of short-term postoperative complications. Early identification of cognitive frailty could enhance risk stratification and perioperative management for this vulnerable population.