Perioperative adverse cardiac events predict post-discharge mortality after fragility hip fracture in elderly patients without cardiovascular disease
Seung-Chan Kim1
Sook-Jung Kim2
Jeong-Eun Yi2
1.Department of Orthopedic Surgery,Eunpyeong St.Mary's Hospital,College of Medicine,The Catholic University of Korea,Seoul,Korea2.Division of Cardiology,Department of Internal Medicine,Eunpyeong St.Mary's Hospital,Col-lege of Medicine,The Catholic University of Korea,Seoul,Korea
摘要：Background Perioperative adverse cardiac events(PACEs)in elderly patients with hip fractures are associated with perioperat-ive mortality.We investigated the relationship of PACE with post-discharge mortality and further explored whether it differs bet-ween patients with and without cardiovascular disease(CVD).
Methods We retrospectively analyzed data from patients aged ≥ 65 years who underwent fragility hip fracture surgery from September 2016 to December 2021.PACE was defined as a composite of congestive heart failure,cardiogenic shock,myocardial inju-ry after non-cardiac surgery,arrhythmic event,ischemic stroke,or acute pulmonary thromboembolism during hospitalization or within the 30-day postoperative period.Patients with 30-day mortality were excluded.The primary endpoint was all-cause mor-tality after hospital discharge.
Results Of the 446 patients(133 patients in the CVD group and 313 patients in the non-CVD group),14.8％experienced PACE,and overall mortality during a median of 15.9 months(interquartile range:6.6-27.0 months)was 20.9％[CVD(26.3％)vs.non-CVD(18.5％),P=0.064].Patients with PACE demonstrated a significantly worse survival rate than those without PACE in both groups(all log-rank P＜0.05).After adjustment for confounders,PACE was an independent predictor of mortality in the overall popula-tion[hazard ratio(HR)=3.01,95％CI:1.69-5.35,P＜0.001].Its prognostic impact was significant in patients without CVD(HR=2.69,95％CI:1.35-5.38,P=0.005)but not in those with CVD(HR=1.20,95％CI:0.41-3.50,P=0.735).
Conclusions PACE was associated with increased post-discharge mortality after fragility hip fracture,especially in elderly pa-tients without CVD.
机标关键词：predictafteradversecardiaccardiovasculardiseaseelderlyevents
论文发表日期：2024-12-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：10( 1099-1108 )