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Introduction: Our study aimed to determine the impact of preoperative red blood cell distribution width on length of intensive care unit and hospital stays, and short- and long-term mortality in elderly patients undergoing hip fracture surgery. Materials and Method: This prospective cohort study included 414 patients aged 65 and older who presented with hip fractures between November 2021 and November 2022. Patients' demographic characteristics, American Society of Anesthesiologists score, Revised Cardiac Risk Index, comorbidities, and preoperative complete blood counts (hemoglobin, red blood cell distribution width, platelet count, etc.) were recorded at the preoperative visit. Length of intensive care unit and hospital stays were documented postoperatively. Patients were followed for one year after surgery in terms of mortality. Results: Patients with high red blood cell distribution width levels (=14.25%) were older, had more comorbidities, and had higher American Society of Anesthesiologists score and Revised Cardiac Risk Index scores (p<0.001). In the high red blood cell distribution width group, length of hospital stays was longer (p<0.001). There was no significant difference between red blood cell distribution width groups in terms of intensive care unit stay duration and readmissions (p=0.304 and p=0.664, respectively). According to the multivariate logistic regression analysis, an red blood cell distribution width of =14.25 was found to increase the risk of 30-day mortality by 4.7 times and 1-year mortality by 2.74 times. Conclusion: Red blood cell distribution width is a useful, practical, and cost-effective indicator of short- and long-term mortality in elderly patients undergoing hip fracture surgery. [ABSTRACT FROM AUTHOR]

Objective: Cardiologists are the most frequently consulted specialists during pre-operative evaluations. However, unnecessary cardiology consultations (CC) can increase cardiologists' workload without impacting anaesthesia practice, resulting in delayed surgeries and additional financial burdens. We hypothesize that using Gupta during the preoperative period can reduce these adverse effects. Methods: This prospective study included patients scheduled for elective noncardiac, nonvascular surgeries who underwent pre-operative assessment. Patients who had no specific risk index used for preoperative cardiac risk evaluation were classified as Group I, and those evaluated using the Gupta scale were classified as Group II. The study compared preoperative CC, diagnostic tests, surgical delays, major adverse cardiac event (MACE), length of hospital stay and intensive care unit (ICU) stay, mortality, and costs. Results: A total of 898 patients were included in the study, with 487 in Group I and 411 in Group II. The Gupta group reduced the demand for preoperative CC (P<0.001) and preoperative non-invasive diagnostic testing (n = 107, 21.9% vs. n = 36, 8.75%). The time from the anaesthesiology outpatient clinic to surgery was 15 days in Group I and 14 days in Group II (P=0.132). The length of ICU stay was higher in Group I (P=0.019). MACE was 15 patients (3.08%) in Group I and 9 patients (2.19%) in Group II (P=0.076). The cost of patients in Group I was higher than that in Group II (P=0.019). Conclusion: Using Gupta in preoperative evaluation may reduce unnecessary preoperative resource usage, surgical delays, ICU hospitalization rates, additional costs, and mortality. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to evaluate the impact of the pandemic on clinical practice and education of anaesthesiology and reanimation residents in Turkey. Methods: A 33-question web-based survey was sent to anaesthesiology and reanimation residents in Turkey. Residents were asked about their clinical practice and education before and during the pandemic and personal perspectives on working conditions and training. Results: A total of 223 residents participated. Median working time in the intensive care unit of 2.5 months/year before the pandemic increased to 6 months/year during the pandemic (P < .001). Median working time in the operating room of 9 months/year decreased to 6 months/year (P < .001). The time working in the algology and anaesthesiology outpatient clinic decreased significantly (both P < .001). Neuraxial and peripheral nerve block practices decreased (P = .002 and P = .023, respectively). The number of night shifts per month increased (P < .001). While the average number of beds in intensive care units was 14, it increased to 19.5 beds (P < .001). The education time for lecture and clinical case discussion decreased (P < .001), but medical meeting attendance did not change (P = .174). Eighty-seven percent of the residents reported that night shifts were very intense and intense during the pandemic. For 87.3% of the respondents, the workload increased, and 71.6% of the respondents reported a decrease in theoretical education and 66.7% in practical training. Sixty-three percent of last year residents reported that they were negatively and very negatively affected in making the thesis. Conclusion: The pandemic had a negative impact on anaesthesiology and reanimation residency training programs in Turkey. [ABSTRACT FROM AUTHOR]

Introduction: The goal of this study was to identify potential predictors of intensive care unit (ICU) expenses in geriatric patients after hip fracture surgery. The research focused to investigate patient-related characteristics and fracture status markers that contribute to increased ICU and overall costs in geriatric hip fracture surgical patients. Materials and Method: A retrospective review of patients who had hip fracture surgery and required intensive care was performed between January 1, 2020 and December 31, 2021. Patient variables were collected via hospital information management system including demographics, co-morbidities, length of stay in ICU and hospital, AO/OTA fracture classification and APACHE score. Hospital Invoice Service provided total and daily intensive care treatment charges and costs. The Spearman correlation coefficient was used to show the relationship between some variables and multiple linear regression analysis was used to evaluate the variables that impact the cost. Results: Intensive care unit expenses constituted 18.92% of the entire cost (1252.46±282.838 TL). APACHE score, Age-adjusted Charlson Comorbidity Index (ACCI), ICU length of stay and hospital length of stay was found statistically significant correlation with ICU expenses (p<0.05). Regression analysis revealed statistically significance with length of hospital stay, fracture score, ASA, APACHE and ACCI (p=0.000) (r2=0.236). When evaluated in a linear regression model, APACHE score (p=0.000), ACCI (p=0.027), and hospital length of stay (p=0.001) were the only statistically significant predictors. Conclusion: The present study found out that length of hospital stay, APACHE and ACCI can be used as cost drivers that help to predict cost of intensive care for geriatric hip fract [ABSTRACT FROM AUTHOR]