Ahmed Talha, Safdar Ayesha
Internal Medicine, University of Maryland Medical Center, Baltimore, USA.
Internal Medicine, Army Medical College, Rawalpindi, PAK.
Cureus. 2020 Apr 3;12(4):e7527. doi: 10.7759/cureus.7527.
Acute hip fractures (AHF) are common in elderly patients. A combination of age-related osteoporosis and increased fall risk makes this population group most susceptible to different fractures including acute fracture of the hip. AHF is a disabling condition that warrants immediate attention. It has a huge impact on the already compromised baseline functional status of elderly patients rendering them more susceptible to different morbidities and even mortality. Similarly, age-related degeneration of the aortic valve with resulting calcification also makes elderly patients prone to aortic stenosis (AS). Severe asymptomatic AS when diagnosed in these patients with AHF in the perioperative period makes the management options very challenging. Severity of AS usually translates into worse postoperative outcomes. The management rationale of concomitant presence of these two conditions is unclear. There is a lack of clear-cut recommendations and societal guidelines in such scenario.
急性髋部骨折(AHF)在老年患者中很常见。与年龄相关的骨质疏松症和跌倒风险增加,使得这一人群最易发生包括髋部急性骨折在内的不同骨折。AHF是一种需要立即关注的致残性疾病。它对老年患者本已受损的基线功能状态有巨大影响,使他们更容易发生不同的疾病甚至死亡。同样,与年龄相关的主动脉瓣退变并伴有钙化,也使老年患者易患主动脉瓣狭窄(AS)。在围手术期,这些AHF患者被诊断出患有严重无症状AS时,管理选择非常具有挑战性。AS的严重程度通常会导致更差的术后结果。这两种情况同时存在的管理原理尚不清楚。在这种情况下,缺乏明确的建议和社会指南。