Table 1 Perioperative management measures

1. The super elderly patients with hip fracture received monitor of electrocardiogram, mean arterial pressure and pulse oxygen saturation to ensure timely detection and treatment of complications [11, 12].

1. Evaluation and education: Electrocardiogram, mean arterial pressure, and pulse oxygen saturation were monitored in patients. A comprehensive geriatric examination was performed after admitted to identify potential risks and intervene in a timely manner [13]. The health care should be effectively preached, especially nutritional education.

2. Patient who recently had weight loss or a low body mass index on admission received assessment of nutritional status. Nutrition therapy was only available for a subset of patients [14].

2. Nutritional support: Patients were assessed for their nutritional status and performed nutritional treatment according to the specific situation. Use of probiotics and prokinetics was to prevent acute gastrointestinal dysfunction. Oral feeding was the main method. If food intake was insufficient, a nasogastric tube should be inserted to avoid electrolyte imbalance. Milk powder, protein powder, and enteral nutritional suspension were utilized as nutritional supplement [15, 16].

3. Patients with pulmonary infection or respiratory failure received oxygen treatment.

3. Respiratory management: Chest physiotherapy and breathing exercises were important, which included actively cough, accessary posture productive cough and turnover [17]. Low flow inhale oxygen and atomize were indispensable measures [10]. The patient received aerosol treatment of salbutamol sulfate, ipratropium bromide, and budesonide twice a day.

4. In order to prevent deep vein thrombosis, low molecular weight heparin and ankle pump exercise were administered according to the circumstances [18].

4. Volume management: The purpose of perioperative rehydration was to maintain fluid balance as much as possible [19].

5. To ameliorate pain, analgesics including opioid, nonsteroidal anti-inflammatory drug, or acetaminophen were given.

5. Blood management: In consideration of comorbidities and overall condition, patients were recommended to maintain an HGB level of at least 10 g per deciliter [18, 20,21,22].

6. Patients with suspected urinary retention received a single catheter. If urinary retention persisted, the catheter would remain in place for several days according to the circumstances [14].

6. Thrombus management: Actively take basic prevention, physical prevention, drug prevention and other measures to prevent lower extremity deep vein thrombosis [23, 24].

7. No food was allowed within 8 hours before the operation.

7. Pain management and sedation: Multimodal analgesia was suggested by clinical guidelines, included effective early analgesia, analgesic drugs and patient-controlled analgesia [16]. The mechanism of perioperative restlessness and delirium was complex [23, 24]. Identifying triggers and remove them were important, rather than rushing to medication.

8. Tube management: Urinary retention was relieved by a single catheterization, and the second remained urethral catheter in place for 1 to 2 days [14].

9. Carbohydrate-rich drinks and water might be consumed up to 2 hours before the operation. A normal diet was allowed 6 hours before the operation. The exceptions to this were patients experienced delayed gastric emptying and intestinal obstruction.