Risk factors for adverse cardiac events within 30 postoperative days in aged patients with hip fracture / 中华创伤骨科杂志

ABSTRACT

Objective:To explore the risk factors for adverse cardiac events within 30 postoperative days in the aged patients with hip fracture.Methods:We retrospectively evaluated the clinical data of 1, 004 aged patients who had been admitted to Department of Orthopaedics, The 7th Medical Center, PLA General Hospital for hip fractures from January 2012 to December 2016. According to whether cardiac complications occurred within 30 days after operation, they were divided into 2 groups a group with adverse cardiac events and a group free from adverse cardiac events. The 2 groups were compared in terms of age, gender, concomitant disease, timing of surgery, type of surgery and anesthesia mode. Multivariate Logistic regression analysis was used to determine the independent risk factors of adverse cardiac events 30 days after operation. In addition, the 2 groups were also compared in 30-day mortality, 1-year mortality, and total mortality postoperation.Results:Adverse cardiac events occurred in 45 patients (4.5%) within 30 days after operation. The multivariate Logistic regression analysis showed that advanced age ( OR=1.085, 95% CI 1.033-1.139), chronic renal insufficiency ( OR=5.296, 95% CI 2.172-12.910), cardiac insufficiency ( OR=2.938, 95% CI 1.283-6.729), delayed operation ( OR=3.682, 95% CI 1.110-12.220) were independent risk factors for cardiac adverse events 30 days after operation. The 30-day mortality, 1-year mortality, and total mortality postoperation were respectively 17.8% (8/45), 26.7% (12/45) and 46.7% (21/45) for the group with adverse cardiac events, and respectively 3.6% (35/959), 9.1% (87/959) and 28.5%(273/959) for the group free from adverse cardiac events, showing significant differences between the2 groups (all P<0.05). Conclusions:Advanced age, cardiac insufficiency, chronic renal insufficiency and delayed surgery may be independent risk factors for adverse cardiac events within 30 days after surgery in the elderly patients with hip fracture who show a significantly higher mortality than those free from adverse cardiac events.