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Prediction of Early Postoperative Major Cardiac Events and In-Hospital Mortality in Elderly Hip Fracture Patients: The Role of Different Types of Preoperative Cardiac Abnormalities on Echocardiography Report

Clinical interventions in aging, 2020-01, Vol.15, p.755-762 [Peer Reviewed Journal]

2020 Chen et al. ;COPYRIGHT 2020 Dove Medical Press Limited ;2020. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;2020 Chen et al. 2020 Chen et al. ;ISSN: 1178-1998 ;ISSN: 1176-9092 ;EISSN: 1178-1998 ;DOI: 10.2147/CIA.S250620 ;PMID: 32546993

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Title:
Prediction of Early Postoperative Major Cardiac Events and In-Hospital Mortality in Elderly Hip Fracture Patients: The Role of Different Types of Preoperative Cardiac Abnormalities on Echocardiography Report
Author: Chen, Xuepan ; Ma, Yuanchen ; Deng, Zhantao ; Li, Qingtian ; Liao, JunXing ; Zheng, Qiujian
Subjects: Aged ; aging ; Analysis ; Aortic valve stenosis ; Aortic Valve Stenosis - diagnostic imaging ; Aortic Valve Stenosis - epidemiology ; Biomarkers ; Cardiac arrhythmia ; Cardiovascular disease ; Cardiovascular Diseases - diagnosis ; Cardiovascular Diseases - epidemiology ; China ; Comorbidity ; Coronary heart disease ; Diseases ; echocardiograph abnormality ; Echocardiography ; Echocardiography - methods ; Echocardiography - statistics & numerical data ; Ejection fraction ; Elderly ; Elderly patients ; Electrocardiography ; Female ; Fracture Fixation - adverse effects ; Fracture Fixation - methods ; Fractures ; Fractures (Injuries) ; Health aspects ; Health risk assessment ; Heart attacks ; Heart failure ; Heart hypertrophy ; Heart valve diseases ; hip fracture surgery ; Hip Fractures - epidemiology ; Hip Fractures - surgery ; Hip joint ; Hospital Mortality ; Hospitals ; Humans ; Hypertrophy ; Male ; Medical records ; Medical tests ; Mitral valve stenosis ; Mortality ; Multivariate analysis ; Original Research ; Patients ; postoperative cardiac complications ; Postoperative Complications - diagnosis ; Postoperative Complications - etiology ; Postoperative Complications - mortality ; Prognosis ; Pulmonary arteries ; Risk Factors ; Stenosis ; Surgery
Is Part Of: Clinical interventions in aging, 2020-01, Vol.15, p.755-762
Description: Transthoracic echocardiography (TTE) is a common cardiac screening test before hip fracture surgery. However, the general TTE test delays surgery, so it would be meaningful if we could simplify the TTE by only assessing cardiac abnormality specifically. Therefore, we aimed to establish the most clinically relevant abnormality by comparing the predictive value of each major cardiac abnormality in postoperative cardiac complications and mortality in elderly hip fracture patients. From January 2014 to January 2019, the medical records of all surgically treated elderly patients (>65 years) with hip fracture were analyzed. The major TTE abnormalities were defined as left ventricular hypertrophy, systolic pulmonary arterial pressure >25 mm Hg, moderate-severe valve abnormality, left ventricular ejection fraction (LVEF) <50%, and pericardial effusion. The outcomes were postoperative cardiac complications and in-hospital mortality. There were 354 patients involved finally. Postoperative cardiac complications were encountered in 7.6% (n=27) of patients. The mortality rate was 2.8% (n=10). History of coronary artery disease (CAD) (OR: 3.281, 95% CI: 1.332-8.079, p=0.010) and presence of aortic stenosis (AS) (OR:5.656, 95% CI: 1.869-17.117, p=0.002) were independent predictors of postoperative cardiac complications. In addition, age (OR: 1.264, 95% CI: 1.047-1.527, p=0.015), history of CAD (OR: 19.290, 95% CI: 2.002-185.885, p=0.010), presence of AS (OR:7.164, 95% CI: 1.988-51.413, p=0.040) and LVEF <50% (OR:8.803, 95% CI: 1.115-69.472, p=0.039) were independent predictors of mortality. However, the rest of preoperative TTE abnormalities were not associated with postoperative cardiac complications or mortality. Among the TTE abnormalities presented by elderly patients with hip fracture, moderate-severe AS was the predictor of postoperative cardiac complications. Moreover, moderate-severe AS and LVEF <50% were the predictors of in-hospital mortality. Therefore, we could simplify the TTE process by assessing aortic valve and LVEF specifically on focused echocardiography, which could avoid surgery delay.
Publisher: New Zealand: Dove Medical Press Limited
Language: English
Identifier: ISSN: 1178-1998
ISSN: 1176-9092
EISSN: 1178-1998
DOI: 10.2147/CIA.S250620
PMID: 32546993
Source: Geneva Foundation Free Medical Journals at publisher websites
AUTh Library subscriptions: ProQuest Central
DOVE Medical Press OA Journals
MEDLINE
PubMed Central
DOAJ Directory of Open Access Journals

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Prediction of Early Postoperative Major Cardiac Events and In-Hospital Mortality in Elderly Hip Fracture Patients: The Role of Different Types of Preoperative Cardiac Abnormalities on Echocardiography Report

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