Affiliations: [a] Department of Orthopaedic, Taksim Training and Research Hospital, Istanbul, Turkey | [b] Department of Orthopaedic, Istanbul University Istanbul Medical School, Istanbul, Turkey | [c] Department of Orthopaedic, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey | [d] Department of Cardiology, Medipol University Medical School, Istanbul, Turkey
Correspondence:
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Corresponding author: Harun Mutlu, Department of Orthopaedic, Taksim Education and Research Hospital, Istanbul, Turkey. Tel.: +90 555 623 26 23; Fax: +90 212 571 47 90; E-mail: drharunmutlu@yahoo.com
Abstract: OBJECTIVE: To investigate the effects of preoperative cardiac tests
on the surgical treatment plan and subsequent effects on mortality in
elderly patients with hip fracture. METHODS: In this retrospective study, 116 patients aged 60 years or
above who underwent hip fracture surgery between 2010-2013 were evaluated.
Of the patients with similar preoperative clinical risk factors, 20 patients
with additional preoperative cardiac tests such as echocardiography or
thalium scintigraphy constituted Group 1, whereas 28 patients without
additional cardiac tests constituted Group 2. Statistical analyses were
performed using the SPSS 21 statistical package software. Normal
distribution of the data was determined by the Shapiro-Wilk test and
histography. Intergroup and mortality comparisons were performed by
Mann-Whitney U, Yates-corrected chi-square and Fisher's exact tests. RESULTS: The mean time between fracture and operation was 6 days
(range, 4-14) in Group 1, and 2 days (range, 0-3) in Group 2. There was a
significant difference in time-to-operation between the groups (p< 0.001).
The age and gender distribution of both groups were homomgenous (p= 0.64, p= 1.0). Both groups were comparable in terms of fracture type, treatment,
and anesthesia (p= 0.36, p= 0.42, p= 1.0). At the end of 1 year, six (30%)
patients in Group 1 and three (10.7%) patients in Group 2 were deceased.
Both groups were comparable in terms of mortality (p= 0.137). There was a significant difference between the two groups in terms of complications
(p< 0.05). CONCLUSIONS: Unnecessary cardiac tests in elderly patients with hip
fracture led to a delay in their surgery, yet did not change their cardiac
treatment plan. This delay in obtaining hip fracture surgery increases
complication rates, hospitalization duration, and costs.
