Evaluation of ASA, SORT and CACI scores in prediction of the need of postoperative intensive care after orthopedic hip surgery

In this retrospective study; We aimed to investigate the effectiveness of ASA, CACI and SORT scoring systems in predicting the need for postoperative intensive care in patients undergoing hip surgery. The study was conducted by examining the hospital records of patients who were operated on at Gaziantep University Şahinbey Practice and Research Hospital between April 2016 and August 2021. A total of 545 patients over 65 years of age who underwent elective surgery for femoral neck fracture and intertrochanteric fracture of the femur were included in the study. Group 1: Patients with an ICU indication in the preoperative evaluation and followed up in the ICU after surgery Group 2: Patients with an ICU indication in the preoperative evaluation and transferred to the service without the need for post-operative ICU follow-up Age, gender, ASA score, smoking, type of surgery, type of anesthesia applied, and co-morbidities of the patients admitted to the groups were noted. SORT score and CACI index results were recorded by entering and calculating patient data electronically. Of the 450 patients who requested an ICU in the preoperative period, 190 were followed up in the ICU in the postoperative period. The waiting time before surgery was found to be higher in Group I compared to Group II (p=0.01). When the age of the patients (p=0.03) was compared, it was found to be higher in Group I patients (p<0.05). HT was found in 64.7% of Group I patients and DM was found in 41.1%, which was found to be higher than Group II (p=0.03). Exit from the hospital resulted in 15.3% of Group I patients and 5% of Group II patients, and it was found to be statistically significantly higher (p=0.01). Postoperative Hgb and preoperative albumin values were found to be significantly lower in Group I patients compared to Group II (p=0.01). The CACI score was found to be higher in Group I patients (p=0.02). There was no significant difference between the two groups in SORT scores (p>0.05). ROC analysis was used to determine the cut-off point for the CACI variable and the cut-off point was determined as 6 points (p=0.02). The sensitivity of CACI was 42.1%, and the specificity was 70.8%. The ASA score was high in all of the patients we included in the study. 85.1% of the patients were in the ASA III risk group. Advanced age, presence of DM and HT, long waiting time before surgery, low postoperative hemoglobin and preoperative albumin levels, and increased CACI index were found to be the determining risk factors in predicting the need for postoperative intensive care in patients undergoing hip surgery.