Risk factors for new cardiac adverse events in the elderly after hip fractureoperation
Received:September 09, 2019  
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DOI:10.11915/j.issn.1671-5403.2020.07.122
Key words:aged  hip fracture  adverse cardiac events  risk factors This work was supported by the Horizontal Project of National Key Research Development Plan of the Science and Technology Ministry
Author NameAffiliationE-mail
YANG Bo First Department of Orthopaedics,Beijing 100095, China xiaoli_0427@yeah.netrisk 
YANG Jin-Cai Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China xiaoli_0427@yeah.netrisk 
ZANG Chuan-Yi First Department of Orthopaedics,Beijing 100095, China xiaoli_0427@yeah.netrisk 
LIANG Zhi-Lin First Department of Orthopaedics,Beijing 100095, China xiaoli_0427@yeah.netrisk 
ZHAO Xiao-Lin First Department of Orthopaedics,Beijing 100095, China xiaoli_0427@yeah.netrisk 
CHEN Xiao-Li Department of Cardiology, Beijing Geriatric Hospital, Beijing 100095, China xiaoli_0427@yeah.netrisk 
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Abstract:
      Objective To study the risk factors for new cardiac adverse events during post-operative hospitalization in the elderly patients with hip fracture. Methods A retrospective analysis was conducted on the elderly patients over aged 65 years with hip fracture undergoing surgical treatment in Beijing Geriatric Hospital from July 2014 to June 2018. Their baseline data, preoperative complications and anesthetic modes were collected and analyzed for the clinical features and risk factors of new cardiac adverse events during hospitalization. The data were processed with SPSS statistics 22.0. Multivariate logistic regression analysis was used to analyze the statistically significant indices found by univariate logistic regress analysis. Results A total of 418 patients were enrolled in this study, and they are at a mean age of (76.7±9.2) years and had an average length of hospital stay of (13.2±6.8) d. There were 56 cases reporting new adverse cardiac events during hospitalization (13.4%, cardiac events group). Three patients died due to cardiac events, accounting for 0.72% (3/418). And the left 362 cases were assigned into the non-cardiac events group. Significant differences were seen in the ratios of patients with abnormal electrocardiogram, left ventricular ejection fraction ≥50%, hemoglobin ≥90g/L, albumin ≥33g/L, pro-B-type natriuretic peptide ≥450 pg/ml, general anesthesia and electrolyte disturbance after operation between the cardiac and non-cardiac events groups (P<0.05). Multivariate logistic analysis showed that the history of cardiovascular diseases (OR=13.58, 95%CI 10.12-21.39; P<0.01), combination of basic diseases of internal medicine (except cardiovascular system) >4 (OR=5.28,95%CI 1.21-15.25; P<0.01), ASA grade Ⅲ/Ⅳ(OR=4.01,95%CI 3.24-10.34; P<0.01), age >70 years(OR=2.86, 95%CI 1.05-7.55; P<0.05), serum albumin <33g/L (OR=2.61,95%CI 1.23-5.51; P<0.01), hemoglobin <90g/L (OR=1.81,95%CI 1.03-6.21; P<0.01), electrolyte disturbance (OR=1.11,95%CI:1.02-2.34; P<0.01) were independent risk factors for new cardiac adverse events in elderly patients after operation for hip fracture. Conclusion Cardiac adverse events after hip fracture surgery in the elderly are the result of multiple factors. Special attention should be paid to those with history of cardiovascular diseases.
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