Key result
Atrial fibrillation is present in 12-15% of hip fracture patients and is associated with increased inpatient and post-discharge mortality and readmission rates.
Why the study?
AF and hip fractures are both prevalent in the elderly, prompting a systematic review of their association and the impact of AF on hip fracture prognosis.
Is atrial fibrillation associated with an increased rate of hip fractures and worse prognosis in hip fracture patients?
Systematic Review (n=42)
Is atrial fibrillation associated with an increased rate of hip fractures and worse prognosis in hip fracture patients?
Atrial fibrillation frequently coexists with hip fractures and is associated with increased mortality and readmission rates in this vulnerable population.
Supports AF assessment in hip fracture pathways; hypothesis-generating and requires prospective trials to guide management.
BACKGROUND: Atrial fibrillation (AF) and hip fractures are both prevalent in the elderly population. The aim of this study was to systematically review the literature regarding the association between AF and hip fractures, and the impact of AF on hip fracture prognosis. METHODS: The literature search was performed using PubMed, MEDLINE, Embase and Scopus. Inclusion was based upon the application of eligibility criteria in duplicate prior to data extraction with a standardized form. RESULTS: A total of 42 studies met the inclusion criteria. AF prevalence was found to vary between 6.5% and 35% in cohorts. Large studies with broad inclusion criteria found the prevalence of AF in hip fracture patients to be approximately 12-15%. There were conflicting results as to whether patients with AF have an increased rate of hip fractures, as compared to patients without AF. Several studies demonstrated that hip fracture patients with AF have increased rates of mortality, both as an inpatient and following discharge, and increased readmission rates. CONCLUSION: AF and hip fractures frequently coexist, and there is evidence to suggest AF is associated with increased readmission and mortality rates in hip fracture patients. Elements of the relationship between AF and hip fractures remain uncertain and further prospective studies on AF and hip fracture cohorts may clarify this relationship. Interventional studies targeting hip fracture patients with AF may be beneficial.
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Abu‐Assi et al. (2019) conducted a systematic review in Atrial fibrillation and hip fractures (n=42). Atrial fibrillation vs. No atrial fibrillation was evaluated on Prevalence of AF in hip fracture patients, rate of hip fractures, mortality, and readmission rates. Atrial fibrillation is present in 12-15% of hip fracture patients and is associated with increased inpatient and post-discharge mortality and readmission rates.
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