Background and Objective: The peri-anaesthetic management of an elderly patient is significantly different from that of a young patient. This study was conducted to determine the morbidity and mortality of elderly patients undergoing anaesthesia for orthopaedic surgery at Monkole Hospital and the factors associated with it. Methods: This cross-sectional, single-centre study was carried out at Monkole Hospital from 01 January 2011 to 31 December 2022. It included all patients aged at least 60 years who underwent anaesthesia for orthopaedic surgery. The sample used was exhaustive, based on a patient register. Peri-anaesthetic data were collected ethically up to hospital discharge and analysed with SPSS 26.0 for p < 0.05. Results: Out of 1637 anaesthetised orthopaedic patients, a sample of 132 was collected including 69 men (52.3%) and 63 women (47.7%), with a sex ratio M/F of 1.09 with a mean age of 68.5 ± 6.9. BMI was normal in 46.2% of patients, obesity in 28%, cardiovascular (64.4%) and renal-metabolic (38.6%) co-morbidities predominated, thrombo-embolic risk was present in 83.3%, ASA class was 2 (69.7%), 3 and 1 (15.2% each). The surgical procedures were often major, including hip (25.7%) and knee (11.3%) replacements, and osteosynthesis with (18.9%) or without an external fixator (12.1%). Patients transfused intraoperatively had significantly lower haemoglobin levels than those who were not transfused (p < 0.005). Peri-medullary anaesthesia was used in 72% of cases and general anaesthesia in 23.5% of cases where the procedure was often scheduled (95.5%). Intraoperative incidents were mainly arterial hypotension in 21.96% of cases, and 19.7% benefited from intraoperative transfusion. Post-operative complications were pulmonary embolism (two cases, 1.5%), surgical revision (1.5%) and two deaths (1.5%) related to pulmonary embolism. Conclusion: Although in a low-income country, anaesthesia of the elderly in orthopaedic surgery appears to be frequent with few complications dominated by arterial hypotension probably linked to the frequent use of perimedullary anaesthesia.
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