Key result
Preoperative bedside echocardiography in high-risk patients with hip fracture did not significantly delay time to surgery compared to low-risk patients without echocardiography (2.52 vs. 2.33 days).
Why the study?
Clinical guidelines suggest echocardiography before hip fracture surgery, but prospective studies assessing its effect on time to surgery, length of hospital stay, and in-hospital mortality were lacking.
Does preoperative echocardiography improve time to surgery, length of hospital stay, and in-hospital mortality in patients with hip fracture?
Cohort (n=972)
No
Does preoperative echocardiography improve time to surgery, length of hospital stay, and in-hospital mortality in patients with hip fracture?
Absolute Event Rate: 2.52% vs 2.33%
Targeted preoperative echocardiography in high-risk hip fracture patients does not delay surgery and is associated with improved outcomes compared to historical care.
Supports targeted echocardiography feasibility without delay in high-risk hip fracture; leaves open outcome benefits pending randomized trials.
Introduction: Although clinical guidelines suggest echocardiography before surgery in patients with hip fracture, no prospective studies exist in the literature. The aim of the present investigation was to assess whether preoperative echocardiography affects time to surgery, length of hospital stay (LOS), and in hospital mortality in high-risk patients who need surgery for a hip fracture. Material and methods: In the study entered 255 consecutive patients with hip fracture referred to a multidisciplinary hip fracture unit. Seven hundred seventeen patients referred before the implementation of routine echocardiographic examination were considered as control group. Echocardiography was performed in patients with systolic murmurs, unstable clinical conditions, recent decompensation of heart failure or hospital admission for coronary disease. Time to surgery, LOS, and in hospital mortality in patients who underwent preoperative echocardiography (high-risk group) were compared with patients who did not undergo echo (low-risk group) and with the control group. Results: 122/255 patients underwent echocardiography. The two groups did not differ for age, sex, type or fracture, and notably time to surgery and LOS. Coronary heart disease, atrial fibrillation, and two or more comorbidities were more frequent in the echo group. Overall clinical characteristics were not different from group of patients referred before the implementation of the echocardiographic protocol but in these last patients time to surgery and LOS were significantly longer. As well in hospital mortality was not significantly different in the two groups (1.9 in echo vs. 1.7% in nonecho) but lower than in the control group (4.1% ). Conclusions: An echocardiographic guide may be useful in a high-risk group with a hip fracture to choose the proper anesthetic setting, referral for intensive care observation after surgery and, optimal medical treatment, including fluid management without delay in time to surgery.
No takes yet. Share an insight, caveat, or question.
Rostagno et al. (2023) conducted a cohort in Hip fracture (n=972). Preoperative echocardiography vs. No preoperative echocardiography was evaluated on Time to surgery (days). Preoperative bedside echocardiography in high-risk patients with hip fracture did not significantly delay time to surgery compared to low-risk patients without echocardiography (2.52 vs. 2.33 days).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: