Analysis of risk factors of perioperative heart failure in elderly patients with hip fracture

Abstract

Objective To analyze risk factors of the perioperative heart failure following hip fracture surgery in the aged patients and put forward prevention countermeasures so as to reduce the mortality rate for clinical work. Methods The present study included 225 elderly patients who had received hip fracture surgeries from October 2010 to January 2017 in our hospital. Patients were divided into heart failure group (64 cases) and non-heart failure group (161 cases). Single factor analysis was performed in three aspects as preoperative basic situation, preoperative examination and surgical management, the dominant risk factors then rolled into logistic regression analysis to conclude the dependent risk factors of perioperative heart failure. Results Age, systolic blood pressure, delay from admission to operation, ASA classification, numbers of systemic diseases (expect cardiovascular disease), cardiovascular disease, low hemoglobin volume, operative management, blood transfusion ≥400 ml, intraoperative fluid volume, daily liquid volume difference and infusion of human serum albumin were risk factors for perioperative heart failure in elderly hip fractures (χ2=19.861, χ2=7.075, χ2=8.732, χ2=25.504, χ2=29.226, χ2=45.825, χ2=14.362, χ2=6.662, χ2=8.190, χ2=7.216, χ2=30.086, χ2=10.122, χ2=12.079, P<0.05). The logistic regression analysis showed that combined with more than 4 underlying diseases, cardiovascular disease, anemia, electrolyte imbalance, perioperative fluid intake, ASA classification were independent risk factors for perioperative heart failure (OR: 5.769, 95% CI: 1.212-36.243; OR: 9.576, 95% CI: 2.118-45.387; OR: 3.686, 95% CI: 1.313-10.349; OR: 6.584, 95% CI: 1.217-26.744; OR: 14.114, 95% CI: 5.021-42.342; OR: 6.012, 95% CI: 3.245-11.329). Conclusions Perioperative heart failure in hip fracture is the result of combination of multiple factors, perioperative risk assessment, early treatment for complications, surgical trauma reduction and postoperative fluid rehydration are the key to reduce perioperative heart failure. Key words: Aged; Hip fractures; Perioperative period; Heart failure