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Previously undiagnosed aortic stenosis revealed by auscultation in the hip fracture population – echocardiographic findings, management and outcome
Author(s) -
McBrien M. E.,
Heyburn G.,
Stevenson M.,
McDonald S,
Johnston N. J.,
Elliott J. R. M.,
Beringer T. R. O.
Publication year - 2009
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2009.05960.x
Subject(s) - medicine , stenosis , auscultation , hip fracture , general anaesthesia , perioperative , cardiology , blood pressure , population , surgery , osteoporosis , environmental health
Summary The 2001 Report of the National Confidential Enquiry into Perioperative Deaths recommended that an echocardiogram should be performed on patients with aortic stenosis prior to anaesthesia. In this study we present the patient details, management and outcome of the 272 hip fracture patients with a previously undiagnosed murmur and echocardiographically proven aortic stenosis admitted from 2001–2005 in our hospital. The patients with aortic stenosis were significantly older, and had significantly lower Abbreviated Mental Test Scores, than the control group of 3698 hip fracture patients without aortic stenosis. There were significant trends toward general anaesthesia over spinal anaesthesia, and use of invasive monitoring of blood pressure, as the severity of the aortic stenosis increased. There were no significant trends towards higher 30‐day or 1‐year mortality rates as the severity of the aortic stenosis increased. Resources for rapid pre‐operative echocardiograms should be made available for hip fracture patients as the results have significant implications for their subsequent anaesthetic management.