A Study of ASA Classification Predicting Hospital-acquired Infection After Hip Fracture Surgery in Elderly Patients

Wang Jun; Wang Hao

Abstract：Objective To investigate the correlation between the American society of anesthesiologists(ASA)classification and the occurrence rate of postoperative hospital acquired infections(HAI),as well as the duration of hospital stay,ICU stay,and hospitalization expenses in elderly patients with hip fractures;and to assess the utility of ASA classification in predicting postoperative HAI.Methods The data of elderly postoperative hip fracture patients admitted to ICU of Beijing Jishuitan Hospital from October,2021 to April,2022 were retrospectively analyzed.According to ASA grade,the patients were divided into ASA Ⅱ group and ASA Ⅲ group.There were 32 males and 51 females in ASA Ⅱ group,with a median age of 87 years old.There were 28 males and 35 females in the ASA Ⅲ group,with a median age of 86 years old.Gender,age,fracture site,anesthesia method,operation method,incidence of postoperative HAI,length of hospital stay,ICU stay and hospitalization cost were compared between the two groups.Multivariate Logistic regression analysis was used to explore the relationship between ASA grade and postoperative HAI.According to receiver operating characteristic(ROC)curve,the value of ASA classification in predicting postoperative HAI after hip fracture in elderly patients was obtained.Results A total of 146 subjects were included in the study,of which 13 had postoperative HAI(8.90％).Compared with ASA Ⅱ group,patients in ASA Ⅲ group had higher incidence of postoperative HAI,longer stay in ICU and more hospitalization costs,and there were statistical differences between the two groups(P＜0.05).Multivariate Logistic regression analysis showed that ASA classification was an independent risk factor for postoperative HAI.ROC curve showed that ASA classification could predict the occurrence of postoperative HAI after hip fracture in elderly patients,and the area under the curve was 0.770(P＜0.05).Conclusion For elderly patients after hip fracture surgery,the incidence of postoperative HAI is higher in those with ASA Ⅲ,the length of ICU stay is longer,and the hospitalization cost is higher.ASA grade has a good predictive value for the occurrence of postoperative HAI.