ASA Score in hip fracture patients

Introduction.– The American Society of Anesthiologists (ASA) physical status classification is commonly used by anaesthetists to score fitness for anaesthesia. Patients are classified into ASA I (normal healthy patient), ASA II (mild systemic disease), ASA III (severe systemic disease), ASA IV (severe systemic disease that is a constant threat to life) and ASA V (moribund patient). Aim.– To study ASA in hip fracture patients and whether it can predict length of hospital stay (LOS) and inpatient postoperative mortality. Methods.– Retrospective analysis of the electronic records of consecutive patients who were admitted with hip fracture in a 19 months period in a UK teaching hospital. ASA grade and mortality were recorded. Results. There were 1199 hip fracture patients admitted in the study period; 73% females and 27% males. The mean age was 81.2 years. Mean LOS was 22.5 days. Inpatient mortality was 9%. 5% patients had ASA I, 48% patients had ASA II, 42% patients had ASA III, 5% patients had ASA IV and 0.4% patients had ASA V. The mean age of patients was 69.1, 80.7, 82.8, 83.3 and 86.2 years respectively (P = 0.0001. The length of hospital stay of patients was10.4, 21.7, 24.4, 27.2 and 11.3 days respectively (P = 0.001). The mortality rate was 3.8%, 6.1%, 7.8%, 25.9% and 60% respectively (P = 0.0001). Conclusion.– Nearly half of hip fracture patients had severe systemic disease preoperatively. The higher the ASA score, the higher is the postoperative mortality following hip fracture surgery especially at ASA scores IV & V. For ASA I to IV: the higher the ASA score, the longer is the length of stay. Disclosure.– No significant relationships.