3761 Pre-emptive holding of antihypertensives after neck of femur fracture surgery: a PDSA audit in an orthogeriatric ward

Abstract Introduction Elderly patients undergoing surgery for neck of femur (NOF) fractures are at high risk of post-operative hypotension due to reduced physiological reserve. Hypotension in this context is associated with an increased risk of cardiovascular events and impaired recovery. Therefore, senior clinicians often pre-emptively hold angiotensin-converting enzyme inhibitors (ACE-Is) and calcium channel blockers (CCBs) for 48 hours post-operatively, but this practice is inconsistently followed by resident doctors. We audited the prevalence and impact of this practice and introduced an intervention to improve consistency. Methods A two-cycle audit was conducted on an orthogeriatric ward. Inclusion criteria were patients aged >65 requiring surgery for NOF fractures. Data collected included antihypertensive use on admission, whether antihypertensives were held post-operatively, systolic blood pressure on post-operative days (POD) 1–3, episodes of moderate (90–100 mmHg) and severe (