Aims: Hip fractures carry significant mortality and morbidity risk in elderly population. While intraoperative hypotension has been widely studied, predictors of postoperative hypotension (POH) in this population remain unclear. This study aimed to identify factors associated with POH in elderly patients following hip fracture surgery.
Methods: This retrospective cohort study included patients aged 65 years or older, who underwent hip fracture surgery at Blacktown Hospital between January 2019 and December 2023. Measured variables were initially analysed using bivariable analysis with Chi-square testing. Significant factors were included in multivariable logistic regression analysis.
Results: A total of 692 patients were included, of whom 160 (23.1%) developed POH. Significant predictors included spinal anaesthesia (OR 3.03; 95% CI 1.61–5.72, p=0.001) and presence of intraoperative hypotension (OR 2.11; 95% CI 1.27–3.48, p=0.004). Other significant factors identified by bivariable analysis include history of heart failure, arrythmia, ischaemic heart disease, and post-operative anaemia. Patients who experienced POH were associated with higher rates of failure to mobilize on day 1 (OR 5.44; 95% CI 3.04–9.75, p<0.001), intensive care unit admission (OR 13.38; 95% CI 7.45–24.04, p<0.001), and acute kidney injury (OR 2.73; 95% CI 1.47–5.10, p=0.002). There was no significant association between POH with 30-day or 120-day mortality.
Conclusions: Our study highlights spinal anaesthesia and presence of intraoperative hypotension are major predictors for post operative hypotension. Prospective studies are needed to validate these findings and inform perioperative management strategies.