Acta Orthopaedica et Traumatologica Turcica

Impact of echocardiography on one-month and one-year mortality of intertrochanteric fracture patients

AOTT 2018; 52: 97-100
DOI: 10.1016/j.aott.2017.12.006
Read: 936 Downloads: 485 Published: 06 February 2020
Abstract

Objective
The aim of this study was to analyze the effects of preoperative echocardiography on patient survival, timing of surgery in length of hospital stay in patients who will undergo hip nailing for an intertrochanteric fracture.
Methods
The clinical records of the patients who were admitted to a tertiary university hospital with an intertrochanteric femur fracture were retrospectively analyzed. The age, gender, American Society of Anesthesiologists (ASA) score, days to surgery, total hospital stay, cardiac drug prescription/modification, cardiac intervention and presence of an echocardiography assessment including detailed findings were reviewed. Mortality data were accessed from the national civil registration system.
Results
181 (110 women and 71 men; mean age 81 (44–98)) cases were studied whom 65 underwent pre-operative echocardiography. Time to surgery and total hospital stay was 2 days longer at transthoracic echocardiography (TTE) group (p < 0.001). At one month control group survival rate was 93.1% on contrary it was 75.4% at TTE group. One-year survival rates were 77.3% and 55.1% respectively. Likewise mean expected survival time was 21.6 ± 1.03 months for control group and 15.12 ± 1.64 months for TTE group (p < 0.001). Only increased left ventricular end diastolic diameter (LVEDD) was showed to be associated with increasing one-year mortality with a hazard ratio of 10.78 (2.572–45.19) at multivariate model.
Conclusion
Cardiac findings and requisite for preoperative TTE and increased LVEDD is a strong predictor for mortality. TTE significantly lengthens the time to surgery. Also LVEDD measurement can be easily performed in the bedside which we believe would save time and reduce mortality.
Level of evidence
Level III Diagnostic study.
ER -

Keywords

  • Trochanteric fracture
  • Mortality
  • Transthoracic echocardiography
  • Risk assessment

 

 

 

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ISSN 1017-995X EISSN 2589-1294