POSTOPERATIVE ADVERSE CARDIAC EVENTS AND IN-HOSPITAL MORTALITY AFTER HIP FRACTURE SURGERY IN ELDER
Objectives: Hip fractures in elderly due to osteoporosis are becoming a growing major clinical and social concern.
Among elderly patients, hip fractures are associated with an in-hospital mortality rate of 7–14%.To evaluate postoperative
adverse cardiac events after hip fracture surgery and its association with in-hospital mortality after hip fracture surgery.
Material & Methods: This retrospective study was conducted in Orthopedic and Coronary Care Unit (CCU) of District
Head Quarter Hospital, Dera Ismail Khan, between September 2014 to July 2015. Out of 150 patients who undergone
hip surgery in Orthopaedic ward 20 patients presented to CCU postoperatively. Main outcome measures were postoperative
adverse cardiac events and in-hospital mortality after hip fracture surgery.
RESULTS: Total mortality following the hip surgery was 15% and in-hospital 7% while twenty out of one fifty (13%)
patients admitted to Coronary Care Unit (CCU) postoperatively with some adverse cardiac events included:acute coronary
syndrome 5 (3.13%), Cardiac Failure 7 patients (4.38%), arrhythmias 4 (2.5%), pulmonary embolism 4 (2.5%)
and cardiac death.Patients who had been admitted to CCU had In-hospital mortality of 4% in which 2% admitted with
some comorbidities which was nearly 3 times greater than that for patients who had been initially considered fit for
surgery with significant p value 0.042.
CONCLUSIONS: Elderly patients, after hip fracture surgery, have a higher incidence of Postoperative adverse cardiac
events. Patients who had been admitted to CCU after hip fracture surgery had high In-hospital mortality, patients who
had been admitted with acute medical comorbidities had nearly 3 times greater risk of death than that for patients who
had been initially considered fit for surgery.
Key words: Acute Coronary Syndrome, Cardiac Failure, Cardiac Arrhythmias, pulmonary embolism, Hip Fractures,