Soonchunhyang Med Sci.  2020 Jun;26(1):1-6. 10.15746/sms.20.001.

Association between Preoperative Transthoracic Echocardiography and Clinical Outcomes after Scheduled Hip Fracture Surgery in Geriatric Patients

• Lee M
• Lee SJ
• Kim SH

• KMID: 2505075
• DOI: http://doi.org/10.15746/sms.20.001

Abstract

Objective
Hip fracture is a major problem for elderly patients and is expected to become more common as society ages. Transthoracic echocardiography (TTE) is still widely performed for cardiac risk assessment, while routine echocardiography is not recommended in patients undergoing non-cardiac surgery. Thus, we evaluated the relationship between TTE-related variables and postoperative outcomes in elderly patients with hip fracture.

Methods
This study consisted of a single-center, retrospective medical record review including a total of 356 patients. The study population included patients 65 years of age and older who underwent TTE for preoperative assessment within 1 month before the scheduled hip fracture surgery between January 2013 and October 2016.

Results
In total, 356 patients were included. Seven patients died within 30 days after surgery. Advanced age (odds ratio [OR], 1.14; 95% confidence interval [CI], 1–1.3; P<0.05), increased left ventricular ejection fraction (OR, 1.26; 95% CI, 1.07–1.48; P<0.05), and arrhythmia (OR, 64.99; 95% CI, 3.91–1,079.91; P<0.05) were all significant risk factors for 30-day mortality. Increased left atrium volume was associated with 180-day mortality (OR, 1.02; 95% CI, 1–1.04; P<0.05).

Conclusion
In elderly patients undergoing hip fracture surgery, preoperative TTE is not a useful predictive factor for postoperative mortality.

Keyword

Echocardiography; Hip fractures; Mortality; Geriatrics; Postoperative complications