Abstract
PurposeTo evaluate the association between pre-existing cardiovascular disease (CVD) and the risk of developing post-operative cardiovascular event among elderly patients who underwent hip fracture surgery.MethodsWe performed an observational study among patients with acute hip fracture aged at least 65 years and who received surgical intervention. Hip fracture patients with pre-existing CVD were matched for age, gender, fracture type, and year of admission with patients without pre-existing CVD. The primary endpoint was post-operative cardiovascular events, and patients were followed until discharge from hospital. Conditional logistic regression was used to determine the association between pre-existing CVD and post-operative cardiovascular event after adjusting for potential confounders including age, body mass index, time from fracture to surgery, pre-existing comorbidities, and the Charlson Comorbidity Index (CCI).ResultsThe study matched 858 pairs of patients with and without pre-existing CVD. Post-operative cardiovascular events developed in 40 and 14 patients with and without pre-existing CVD (44.6 versus 16.3 per 1000 persons), respectively. Compared to patients without pre-existing CVD, patients with any pre-existing CVD were more likely to develop post-operative cardiovascular events, with a crude odds ratio (OR) of 2.857 [95% confidence interval (CI), 1.554 to 5.251] and multivariable adjusted OR of 2.850 (95% CI, 1.318 to 7.139), respectively.ConclusionIn elderly patients who received hip fracture surgery, patients with pre-existing CVD are at a higher risk of developing post-operative cardiovascular events. Appropriate screening for this vulnerable population is recommended to prevent the risk of post-operative complications.
Highlights
Hip fracture occurs commonly among the elderly [1] with the number of hip fracture cases expected to rise from 1.6 million in 2000 to approximately 6.3 million in 2050 [2]
After performing the (1:1) matching by age, gender, fracture type, and admission year, 858 patients (94.3%) with pre-existing cardiovascular disease (CVD) were matched to 858 patients without pre-existing CVD (Fig. 1)
We examined the association between preexisting CVD and the risk of developing post-operative cardiovascular events in geriatric patients receiving hip fracture surgery
Summary
Hip fracture occurs commonly among the elderly [1] with the number of hip fracture cases expected to rise from 1.6 million in 2000 to approximately 6.3 million in 2050 [2]. Most patients with hip fracture need surgical intervention. Yan Luo and Yu Jiang contributed to this work. The incidence of post-operative complications in the hip fracture population is disproportionally high due to multiple pre-existing conditions. Post-operative cardiovascular events are frequent [3, 4] accounting for around 40% of all reported complications among patients receiving hip fracture surgery. Identifying patients with the greatest risk of developing post-operative cardiovascular events will help improve preoperative evaluation and inform clinical decision-making in hip fracture surgery
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