Kadir ARSLAN, Ayça Sultan ŞAHİN
Türk Yoğun Bakım Dergisi - 2026;24(2):114-123
Objective: This study aimed to investigate the prognostic value of the Charlson comorbidity index (CCI), American Society of Anesthesiologists (ASA) status, and Acute Physiology and Chronic Disease Evaluation II (APACHE-II) score in critically ill geriatric hip fracture patients followed in the surgical intensive care unit (SICU). Materials and Methods: Critical geriatric hip fracture patients who underwent surgery and were followed in the SICU between January 2022 and December 2023 were evaluated retrospectively. The performance of CCI, ASA status, and APACHE-II scores in predicting in-hospital mortality was investigated. Results: The study included 137 patients, and 66.4% (n=91) were female. ASA IV status, APACHE-II, CCI score, and the number of patients with coronary vascular disease/heart failure were significantly higher in the mortality group (p=0.003, p<0.001, p<0.001, and 0.010, respectively). Mean Glasgow Coma Scale and serum albumin levels at SICU admission were significantly lower in the mortality group (p=0.008 and p=0.006, respectively). ASA status, APACHE-II, and CCI scores were independent predictors of mortality (p=0.002, p=0.022, and p=0.034, respectively). In ROC curve analysis, the area under the curve (AUC) for APACHE-II was 0.803 (95% CI, 0.697-0.908), AUC for CCI was 0.742 (95% CI, 0.598-0.886), and AUC for ASA status was 0.614 (0.458-0.769). Conclusions: CCI, ASA status, and APACHE-II scores independently predict in-hospital mortality in patients with critical hip fractures. It has prognostic value in predicting mortality and is listed from highest to lowest as APACHE-II, CCI, and ASA status.
