EP110 Minute zero point of care ultrasound improves postoperative outcomes in elderly patients undergoing femoral neck fracture surgery

<h3>Background and Aims</h3> ‘Minute Zero’ (MZ) is a structured ultrasound evaluation performed before or after anesthesia to establish a hemodynamic and pulmonary baseline. It aims to personalize anesthetic and fluid strategies, especially in elderly patients with fragility fractures. This study assessed whether MZ could reduce postoperative complications and hospital stay. <h3>Methods</h3> We conducted a prospective observational study in patients &gt;70 years undergoing femoral neck fracture surgery ≥48 h after hospital admission. Patients were divided into two groups: MZ group (n=41), who underwent pre- or postoperative ultrasound; and a control group (n=55), without ultrasound. The MZ protocol included lung ultrasound (to assess B-lines, pleural effusion, consolidation), cardiac contractility, and inferior vena cava evaluation. Management changes based on ultrasound findings were recorded. <h3>Results</h3> Despite a higher mean age (87 vs 84 years) and longer preoperative delay (6.2 vs 5.1 days), MZ patients had a shorter postoperative hospital stay (mean reduction ~3 days). There were no significant differences in postoperative cardiac, respiratory, or infectious complications. However, anesthetic or fluid strategies were modified in over 80% of MZ cases based on findings such as hypovolemia, B-profile, myocardial dysfunction, or pleural effusion. <h3>Conclusions</h3> Minute Zero ultrasound enables early identification of key pathophysiologic conditions, allowing tailored anesthetic and hemodynamic management. In this elderly high-risk population, MZ was associated with a reduction in postoperative hospital stay and influenced perioperative decision-making in most cases.