Open AccessAssociation of Acute Perioperative Myocardial Injury With All-Cause Mortality Within 90 Days After Hip Fracture Repair in the Elderly: A Prospective Study
Author(s) -
Lei Wang,
Meng Cai,
Xiaoying Li,
Xiaohui Deng,
Qiang Xue,
Li Zhou,
Minghui Yang
Publication year - 2022
Publication title -
geriatric orthopaedic surgery and rehabilitation
Language(s) - English
Resource type - Journals
eISSN - 2151-4593
pISSN - 2151-4585
DOI - 10.1177/21514593211070129
Subject(s) - medicine , hip fracture , perioperative , prospective cohort study , orthopedic surgery , mortality rate , renal function , traumatology , surgery , geriatric trauma , incidence (geometry) , injury severity score , osteoporosis , poison control , injury prevention , emergency medicine , physics , optics
It remains unclear whether acute perioperative myocardial injury (APMI) increases mortality in the elderly. This study aimed to investigate APMI’s association with mortality within 90 days after hip fracture repair in elderly patients.Materials and Methods This prospective study enrolled elderly patients admitted to the department of Traumatology and Orthopaedics in XXX Hospital, who underwent surgery in 2018–2019 with a 90-day follow-up. According to survival status within 90 days, survival and death groups were constituted. Clinical, demographic, and laboratory indicators and 90-day mortality post-surgery were recorded. APMI’s association with 90-day mortality post-surgery was analyzed by logistic regression.Results Totally 248 participants were enrolled, including 224 and 24 in the survival and death groups, respectively, for a mortality rate of 9.7%. Compared with surviving individuals, the death group was older [81 (75–86) vs 87 (82–89) years], and had higher incidence rates of APMI (24.6% vs 58.3%), intertrochanteric fractures (41.1% vs 62.5%), preoperative atrial fibrillation (8.9% vs 29.2%), and dementia (73.7% vs 95.8%) (all P<.05). They also showed higher pre-injury frail scale scores [1 (0–2) vs 3 (1–4)] and Nottingham hip fracture scores (NHFSs) [4 (4–5) vs 6.5 (5–7)], lower Glomerular filtration [62 (46.1–78.6) vs 44.37 (35–61.92) ml/min], and reduced odds of glomerular filtration rate <60 mL/min (75.0% vs 46.9%) (all P < .05). APMI (OR = 3.294, 95% CI: 1.217–8.913) and NHFS (OR = 2.089, 95% CI: 1.353–3.225) independently predicted 90-day mortality post-surgery (all P<.05).Conclusions APMI is associated with increased mortality risk within 90 days after hip fracture repair in elderly patients.