Indicators of Operative and Postoperative Complications in Patients Operated for Hip Fracture

Overview

Patients operated for hip fractures are older and have several conditions that have negative influences on the perioperative and postoperative prognosis. Hip fractures can also be painful, which is stressful for the physiology of the patient. Many old patients have received to little fluid intake. They often have diuretic therapy, which even worsens dehydration/hypovolemia. Some patients have to wait several days for surgery. Several studies have shown a high degree of complications and an increased mortality in this patient group. Early preoperative optimization can improve the outcome. The available methods for optimization of the patient are complicated and time consuming. The investigators wish with this study to try new approaches to find which patients still are dehydrated when they come to the operation ward. The aim is to measure the color and density of the urine as well as to register the the variability in the plethysmographic curve before spinal anaesthesia. These results will be compared to circulatory instability during and after surgery as well as to postoperative complications.

All patients with hip fractures planed fore surgery at the Hospital in Norrkoping will come into consideration to participate in study. Many will however not be able to give consent. These will not be included in the study. Directly preoperatively urine will be collected. Color and density will be measured/registered. The pulseoximeter reading will be registered (Saturation, pulse, PI and PVI) before spinal anaesthesia and after spinal anaesthesia as well as during the surgery. Two to three days postoperatively a follow up will be performed, to register complications (Circulatory instability, confusion, infection, affected kidney function/creatinine rise). 30 day postoperative mortality will also be controlled. These results will be compared, to see if pulse oximeter readings or urine concentration can predict complications.

Conditions