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Curr Opin Anaesthesiol ; 37(3): 316-322, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38390903

ABSTRACT

PURPOSE OF REVIEW: Hip fragility fractures (HFF) carry high morbidity and mortality for patients and will increase in frequency and in proportion to the average patient age. Provision of effective, timely care for these patients can decrease their morbidity and mortality and reduce the large burden they place on the healthcare system. RECENT FINDINGS: There are associative relationships between prefracture frailty, postoperative delirium and increased morbidity and mortality. The use of a multidisciplinary approach to HFF care has shown improved outcomes in care with focus on modifiable factors including admission to specialty care floor, use of peripheral nerve blocks preoperatively and Anesthesia and Physical Therapy involvement in the care team. Peripheral nerve blocks including pericapsular nerve group (PENG) blocks have shown benefit in lowering morbidity and mortality. SUMMARY: HFF are associated with >40% chance of continued pain and inability to return to prefracture functional status at 1 year as well as >30% mortality at 2 years. In this opinion piece, we will discuss how a multidisciplinary approach that includes Anesthesia as well as utilization of peripheral nerve blocks can help to lessen postoperative issues and improve recovery.


Subject(s)
Hip Fractures , Nerve Block , Humans , Hip Fractures/surgery , Hip Fractures/mortality , Nerve Block/methods , Aged , Frailty/complications , Frailty/diagnosis , Frailty/mortality , Delirium/etiology , Delirium/prevention & control , Delirium/epidemiology , Delirium/therapy , Postoperative Complications/prevention & control , Postoperative Complications/mortality , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Patient Care Team/organization & administration , Anesthesia/methods , Anesthesia/adverse effects , Osteoporotic Fractures/surgery , Osteoporotic Fractures/mortality , Frail Elderly , Aged, 80 and over
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