Hip fracture clearance: How much optimisation is necessary?. (May 2020)

• Record Type: Journal Article
• Authors: Brink, Ole
• Is Part Of: Injury. Volume 51(2020)Supplement 2
• Page Start: S111
• Page End: S117
• Publication Date: 2020-05
• Subjects: Hip fracture -- Optimisation -- Preoperative -- Surgery; Wounds and injuries -- Surgery -- Periodicals; Accidents -- Periodicals; Wounds and Injuries -- surgery -- Periodicals; Lésions et blessures -- Chirurgie -- Périodiques; Electronic journals; Electronic journals; 617.1
• DOI: 10.1016/j.injury.2020.02.046
• Languages: English
• ISSNs: 0020-1383

Abstract

Highlights: Anaemia, electrolyte disturbances, diabetes, and pneumonia could be corrected without causing substantial delay in operation. Organisational initiatives that aim to optimise the process from the ER to OR are crucial. Anticoagulation therapy interruption is the most common medical reason for a longer surgical delay. Abstract: Patients with hip fractures are typically elderly individuals with several co-morbidities. Upon admission to the hospital, they often present with acute pain, electrolyte disturbances, anaemia, coagulopathy, and delirium. Long waiting times for surgery are associated with increased morbidity and mortality. The balance between the number of clinical tests and optimisation, which may (i.e., fewer complications and better survival) or may not (i.e., more complications and increased mortality due to unnecessary surgical delay) benefit the patient, has been a preoperative challenge. This summary will review existing clinical guidelines and relevant selected studies to evaluate the extent of preoperative optimisation needed prior to hip fracture surgery.