Clinically verified myocardial infarction within 7 days of hip fracture repair occurred in 10.4% of patients and was associated with significantly higher 1-year mortality (35.8%).
Cohort (n=1,116)
Yes
Does early postoperative myocardial infarction increase 1-year mortality in elderly adults undergoing surgical hip fracture repair?
Early postoperative clinically verified myocardial infarction occurs in approximately 10% of elderly patients undergoing hip fracture repair and is independently associated with significantly higher 1-year mortality.
OBJECTIVES: To quantify the occurrence of myocardial infarction (MI) occurring in the early postoperative period after surgical hip fracture repair and estimate the effect on 1-year mortality. DESIGN: A population-based, historical cohort study of individuals who underwent surgical repair of a hip fracture that used the computerized medical record linkage system of the Rochester Epidemiology Project. SETTING: Academic and community hospitals, outpatient offices, and nursing homes in Olmsted County, Minnesota. PARTICIPANTS: Over the 15-year study period (1988-2002), 1,116 elderly adults underwent surgical repair of a hip fracture. MEASUREMENTS: At the end of the first 7 days after hip fracture repair, participants were classified into one of three groups: clinically verified MI (cv-MI), subclinical myocardial ischemia, and no myocardial ischemia. One-year mortality was compared between these groups. Multivariate models assessed risk factors for early postoperative cv-MI and 1-year mortality. RESULTS: Within the first 7 days after hip fracture repair, 116 (10.4%) participants experienced cv-MI and 41 (3.7%) subclinical myocardial ischemia. Overall 1-year mortality was 22%, with no difference between those with subclinical myocardial ischemia and those with no myocardial ischemia. One-year mortality for those with cv-MI (35.8%) was significantly higher than for the other two groups. Occurrence of early postoperative cv-MI, male sex, and history of heart failure or dementia were independently associated with greater 1-year mortality, whereas prefracture home residence and preoperative higher hemoglobin were protective. CONCLUSION: Rates of early postoperative, cv-MI after hip fracture repair exceed rates after other major orthopedic surgeries and are independently associated with greater 1-year mortality.
Huddleston et al. (Tue,) conducted a cohort in Hip fracture (n=1,116). Clinically verified myocardial infarction (cv-MI) within 7 days postoperatively vs. Subclinical myocardial ischemia or no myocardial ischemia was evaluated on 1-year mortality. Clinically verified myocardial infarction within 7 days of hip fracture repair occurred in 10.4% of patients and was associated with significantly higher 1-year mortality (35.8%).