Impact of a Multidisciplinary Algorithm on Early Complications After Hip Fracture Surgery: A Retrospective Time-Series Study
Authors' conclusion
Implementation of the ASAP bundle significantly lowered EPOCs after hip fracture surgery.
Study context
- Population
- Hip fracture patients undergoing surgery
- Participants
- 845 patients
- Exposure
- Post-ASAP bundle vs pre-ASAP period
- Advise, Surgery, Analgesia, Pharmacology (ASAP)n = 365
- pre-ASAPn = 480reference
- Outcome
- Early postoperative complications (EPOCs), all (Clavien-Dindo 1-4) and major (2-4)
- Follow-up
- 7 days
Methodological detailssingle-centre, before-after
- Single-centre
- Before-after
Main finding
As reported in the abstract
7-day EPOCs
ASAP vs pre-ASAPHazard ratio (95% CI)
All EPOCs (Clavien-Dindo 1-4)
0.58(0.49–0.68)
Major EPOCs (Clavien-Dindo 2-4)
0.60(0.49–0.73)
- All early postoperative complications (EPOCs) declined immediately after ASAP implementation
- P = 0.032
- All EPOCs: sustained negative trend over time
- P = 0.008
- Major EPOCs decreased immediately
- P < 0.001
- Major EPOCs: flatter subsequent trend
- P = 0.20
Observational data: associations, not effects.
Further findings
Independent predictors of EPOCs
- Early surgery and SFIB each independently predicted fewer all EPOCs; only early surgery predicted fewer major EPOCs
Original publication
Impact of a Multidisciplinary Algorithm on Early Complications After Hip Fracture Surgery: A Retrospective Time-Series Study. Anesth Analg. Published 27 April 2026. doi:10.
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