The impact of preoperative cardiology consultation on the surgical treatment of patients with proximal femur fractures

Abstract

Introduction. Proximal femur fractures are a common problem in the geriatric population. Moreover, due to numerous comorbidities, the choice of the appropriate form of treatment requires a cardiology consultation. Aim. Therefore, the aim of this study is to analyze whether these consultations have a significant impact on the treatment of patients with proximal femoral fractures. Materials and methods. A total number of 158 patients with a mean age of 81.3 (range, 56-98), treated for femoral neck and trochanteric fractures were enrolled in a retrospective study. Data from the patient’s treatment history were used for the study, such as: age, hospital admission date, cardiological consultation date, surgery date, discharge date or date of death. Results. Patients without cardiology consultation stayed in hospital on average 3.97 days shorter (p = 0.0011) and had surgery on average 2.89 days earlier (p = 0.000001) than patients with an arranged consultation. The percentage of deaths in both groups was similar: 6.1% and 7.1% (p = 0.70068). Spinal anesthesia was mainly performed by anesthesiologists in the group with consultation (64.3%) and without consultation (83.8%) (p = 0.442). More cases with a consultation were disqualified from surgery: 18.8% vs. 2.9% (p = 0.00357). Among the patients with an ordered cardiological consultation, 53.6% had surgery > 48 hours after admission compared to 26.2% patients without consultation (p = 0.0002). Conclusions. Cardiological consultations extend the length of stay in hospital and delay surgical treatment, but do not affect the choice of anesthesia. However, consultation in some cases may help in the proper qualification and disqualification from surgery.