Anesthesiologist-led Teams Speed Up Hip Fracture Surgery, Reduce Complications
A new study reveals that prioritizing anesthesiologist leadership in the preoperative process for hip fracture patients can significantly reduce time to surgery and lower the risk of complications. The findings, presented at the ANESTHESIOLOGY® 2025 annual meeting, underscore the critical role of streamlined care for this vulnerable population.
Hip fractures are a leading cause of hospitalization among older adults, and delays in treatment can have devastating consequences. Unneeded consultations and medical tests frequently enough contribute to surgical postponements of 24 hours or more, sharply increasing the risk of blood clots, infections, and even death. The study highlights how a focused, anesthesiologist-driven approach can mitigate these risks.
The Cost of Delay
For hip fracture patients – who are frequently enough older, frail, and managing multiple health conditions – even short delays can led to a rapid decline in physical and mental well-being. “The faster patients get to the OR to reverse the trauma and start recovery,the better their outcome,” researchers noted. The traumatic nature of the injury and subsequent immobilization exacerbate existing health concerns, making prompt intervention essential.
Traditionally, hip fracture patients are initially assessed by emergency room or orthopedic physicians, who then collaborate wiht internal medicine specialists or hospitalists to admit the patient and schedule surgery. This process can involve ordering a battery of tests – to rule out heart, neurological, or other issues – even when patients lack active symptoms or the results wouldn’t alter immediate treatment plans.
Anesthesiologists Take the Lead
Researchers developed an anesthesiologist-led process implemented early in the admission sequence. These specialists assessed patients to quickly determine their readiness for anesthesia and expedite their path to the operating room. They focused on evaluating the stability of the patient’s heart and lungs, confirming normal standard test results, and identifying less urgent issues that could be addressed post-operatively.In cases where serious problems were detected – such as an uncontrolled heart rhythm or fluid in the lungs – the anesthesiologist collaborated with relevant specialists to establish clear treatment goals and accelerate the patient’s stabilization and surgical preparation.
The study compared outcomes for 130 patients receiving the traditional approach with those of 392 patients managed under the anesthesiologist-led system. The average age of participants in both groups was 79.
Significant Improvements in Patient Outcomes
The results demonstrated a clear advantage for the anesthesiologist-led approach. Patients in this group reached the OR an average of 25.7 hours after admission – approximately five hours faster than the 30.8-hour average for those receiving traditional care. More importantly, the anesthesiologist-led group experienced significantly fewer complications. Specifically, they had 59% fewer heart or lung complications and a remarkable 75% reduction in thromboembolic complications, such as blood clots. There was no statistically significant difference in length of hospital stay, infection rates, or mortality between the two groups.
“Our study demonstrates that a preoperative process primarily led by the anesthesiologist results in markedly improved time to surgery, with fewer complications and no increase in deaths or length of stay,” explained Surya Indukuri, B.S., lead author of the study and a medical student at Zucker School of Medicine at Hofstra University, Uniondale, New York. “We are confident this expedited care will reduce unnecessary testing and shorten hospital stays,which should result in significant cost savings.”
A Growing Public Health Concern
The incidence of hip fractures is rising dramatically alongside an aging population. According to Dr. Sabatino Leffe, D.O., senior author of the study and vice chairman of Northwell southshore University Hospital, Bay Shore, New York, approximately 350,000 Americans fracture a hip each year. These injuries, frequently enough resulting from a combination of osteoporosis and falls, can lead to a loss of mobility, independence, and an increased risk of long-term complications like cognitive decline, chronic pain, pneumonia, and bedsores.
This research suggests a simple, yet powerful, shift in care coordination – empowering anesthesiologists to lead the preoperative process – can dramatically improve outcomes for a growing number of vulnerable patients.
