Key result
Perioperative atrial arrhythmia within 7 days of hip fracture surgery was associated with greater 1-year mortality compared to no arrhythmia (45% vs 21%; HR 2.8, 95% CI 1.9-4.2).
Why the study?
Does the development of perioperative atrial arrhythmia within 7 days of hip fracture surgery increase 1-year mortality in elderly adults?
Cohort (n=1,088)
No
Does the development of perioperative atrial arrhythmia within 7 days of hip fracture surgery increase 1-year mortality in elderly adults?
In elderly adults undergoing hip fracture surgery, the development of perioperative atrial arrhythmia within 7 days is associated with a nearly threefold increased risk of 1-year mortality.
Answers are grounded in this paper and cite their sources.
Supports closer surveillance in elderly hip fracture patients with perioperative atrial arrhythmia; leaves open whether intervention improves survival.
OBJECTIVES: To determine the incidence and 1-year outcomes of an elderly population with perioperative atrial arrhythmia (PAA) within 7 days of hip fracture surgery. DESIGN: Retrospective cohort study. SETTING: The Rochester Epidemiology Project (REP). PARTICIPANTS: Elderly adults consecutive undergoing hip fracture repair from 1988 to 2002 in Olmsted County, Minnesota (N = 1,088, mean age 84.0 ± 7.4, 80.2% female). MEASUREMENTS: Baseline clinical variables were analyzed in relation to survival using Cox proportional hazards methods for comparison. RESULTS: Sixty-one participants (5.6%) developed PAA within the first 7 days. During 1 year of follow-up, 239 (22%) participants died. PAA was associated with greater mortality (45% vs 21%; hazard ratio (HR) = 2.8, 95% confidence interval (CI) = 1.9-4.2). Other mortality risk factors were male sex (HR = 2.0, 95% CI = 1.5-2.6), congestive heart failure (HR = 2.1, 95% CI = 1.7-2.8), chronic renal insufficiency (HR = 2.0, 95% CI = 1.5-2.8), dementia (HR = 2.9, 95% CI = 2.2-3.7), and American Society of Anesthesiologists risk Class III, IV, or V (HR = 3.3, 95% CI = 1.9-5.9). CONCLUSION: Elderly adults undergoing hip fracture surgery who develop PAA within 7 days have significantly higher 1-year mortality than those who do not. Further studies are indicated to determine whether prevention of PAA will reduce mortality in this population.
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Gupta et al. (2015) conducted a cohort in Hip fracture (n=1,088). Perioperative atrial arrhythmia (PAA) vs. No perioperative atrial arrhythmia was evaluated on 1-year mortality (HR 2.8, 95% CI 1.9-4.2). Perioperative atrial arrhythmia within 7 days of hip fracture surgery was associated with greater 1-year mortality compared to no arrhythmia (45% vs 21%; HR 2.8, 95% CI 1.9-4.2).
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