The role of preoperative revised cardiac risk index (Lee criteria) in prediction of early postoperative cardiac and respiratory complications in elderly hip surgeons

In this study, we evaluated the effectiveness of the Preoperative Revised Cardiac Risk Index (Lee Criteria) in predicting early cardiac and respiratory complications after hip surgery in elderly patients. A total of 188 patients over 65 years of age who underwent hip fracture surgery in the Department of Orthopedics and Traumatology at Trakya University Health Application Center Hospital within 18 months were included in the study. In our study, demographic data, comorbidities, Lee Index, albumin value, hemoglobin value, electrolyte values, creatinine value, ECG and ECHO findings, in the preoperative period, type of anesthesia, use of cement, amount of intraoperative fluid given, need for vasopressors or inotropes, need for blood transfusion, case duration, whether there were peroperative complications in the peroperative period. Postoperative period; ICU requirement, need for Cardiology and Pulmonology consultation, newly developed AF, heart failure, presence of pulmonary embolism and pulmonary edema, presence of pneumonia, need for oxygen and bronchodilator support, need for respiratory support if any in the postoperative period (MV, NIMV). Duration of hospital32 stay and hospital discharge were recorded from the patient file, anesthesia follow-up form and hospital information system. In our study, it was observed that the rate of patients being followed up in the intensive care unit increased according to cardiac risk groups, and heart failure, vasopressor/inotrope requirement and pulmonary complications were more common in patients in the high-risk group. The need for cardiology consultation increased with increasing risk group. On the other hand, no significant difference was found between the length of hospital stay and the day of discharge according to the risk groups. Our results suggest that the Revised Cardiac Risk Index based on the Lee Criteria may be a useful tool for predicting the risk of cardiac and respiratory complications after hip surgery in elderly patients.