The impact of compliance with peri-operative ERAS components on postoperative outcomes in elderly population with hip fractures - A prospective observational study

Hip fractures in the elderly are widely recognized to be one of the most morbid conditions in orthopedic surgery. Starting from pre-operative comorbid conditions, to intra operative issues faced by surgeons and anesthesiologists alike, to helping and optimizing conditions for a speedy recovery to premorbid status, the management of hip fractures in the elderly pose a challenge to any healthcare institution taking care of such cases. Many of the patients present with significant medical comorbid conditions, along with other factors like frailty, cognitive dysfunction etc. However, a multidisciplinary ERAS model (Enhanced Recovery After Surgery) is in use in many institutions around the world, to facilitate quick and effective optimization of the patient preoperatively, to ensure safe anesthetic practice, and to hasten the recovery process after surgery and minimizing postoperative complications. ERAS has been successfully used and extensively studied, especially in colorectal and abdominal surgery, and now is being implemented in orthopedic surgery as well. The implementation of such ERAS protocol is highly effective in shortening time to recovery, reducing hospital stay and improving postoperative quality of life in the long run. In this study, we analyze the compliance to internationally accepted components of ERAS for hip fractures in the elderly, to study the outcomes of hip fractures in the same group, and to find out the impact of compliance to ERAS on postoperative outcomes for the patient.