Incidence and risk factors of cardiac complications among patients with osteoporotic hip fractures

Abstract

Objective To estimate the incidence and risk factors of cardiac complications in patients with osteoporotic hip fractures. Methods A retrospective case series study was conducted on the clinical data obtained from 30% of the randomized sample population of Tianjin Urban Employee Basic Medical Insurance database (2009-2014). Patients who had ≥1 diagnoses of hip fracture between 2010 and 2013, aged ≥50 years, and were continuously enrolled from 12 months before (baseline period) to 12 months after (follow-up period) the first osteoporotic hip fracture diagnosis were included in this study. The incidences of cardiac complications were estimated at 3, 6, 9 and 12 months after the fractures, and incidences of cardiac complications which occurred 12 months before and after the fracture were compared. Multiple factors cox proportional hazards regression was used to identify the risk factors of cardiac complications after osteoporotic hip fractures. Results A total of 2 353 osteoporotic hip fracture patients were included [age: (71.4±10.3)years; female: 58.4%]. After hip fracture, the accumulated 12-month incidence of arrhythmia (23.2% vs.9.7%, OR=2.39, 95%CI 2.11 2.72, P<0.01), angina (16.0% vs.7.9%, OR=2.03, 95%CI 1.75 2.35, P<0.01), heart failure (5.9% vs. 2.7%, OR=2.19, 95%CI 1.68 2.85, P<0.01) and myocardial infarction (3.2% vs. 2.0%, OR=1.63, 95%CI 1.19 2.23, P<0.01) were significantly higher than those before fracture, and these complications mostly occurred within 3 months after osteoporotic hip fracture. Patients aged older (OR=1.01, 95%CI 1.00 1.02, P<0.01) with the history of hypertension (OR=1.40, 95%CI 1.14 1.73, P<0.01), coronary heart disease (OR=1.25, 95%CI 1.01 1.53, P<0.05), hyperlipidemia (OR=1.20, 95%CI 1.02 1.42, P<0.05), chronic pulmonary diseases (OR=1.18, 95%CI 1.01 1.38, P<0.05), congestive heart failure (OR=1.70, 95%CI 1.16 2.50, P<0.01), arrhythmia (OR=1.88, 95%CI 1.54 2.29, P<0.01), or renal disease (OR=1.35, 95%CI 1.07 1.69, P<0.05) were at higher risk of cardiac complications. Conclusions The incidence of cardiac complications is significantly increased after osteoporotic hip fractures. Age and disease history at baseline are correlated with the risk factors. Key words: Osteoporositic fractures; Hip fractures; Postoperative complications; Heart diseases; Risk factors