Department of Orthopaedics, Chinese PLA General Hospital, Beijing, China.
National Clinical Research Centre for Orthopaedics, Sports Medicine and Rehabilitation, Beijing, China.
Int Orthop. 2021 Dec;45(12):3045-3053. doi: 10.1007/s00264-021-05227-7. Epub 2021 Oct 13.
To evaluate the association between pre-existing cardiovascular disease (CVD) and the risk of developing post-operative cardiovascular event among elderly patients who underwent hip fracture surgery.
We performed an observational study among patients with acute hip fracture aged at least 65 years and who received surgical intervention. Hip fracture patients with pre-existing CVD were matched for age, gender, fracture type, and year of admission with patients without pre-existing CVD. The primary endpoint was post-operative cardiovascular events, and patients were followed until discharge from hospital. Conditional logistic regression was used to determine the association between pre-existing CVD and post-operative cardiovascular event after adjusting for potential confounders including age, body mass index, time from fracture to surgery, pre-existing comorbidities, and the Charlson Comorbidity Index (CCI).
The study matched 858 pairs of patients with and without pre-existing CVD. Post-operative cardiovascular events developed in 40 and 14 patients with and without pre-existing CVD (44.6 versus 16.3 per 1000 persons), respectively. Compared to patients without pre-existing CVD, patients with any pre-existing CVD were more likely to develop post-operative cardiovascular events, with a crude odds ratio (OR) of 2.857 [95% confidence interval (CI), 1.554 to 5.251] and multivariable adjusted OR of 2.850 (95% CI, 1.318 to 7.139), respectively.
In elderly patients who received hip fracture surgery, patients with pre-existing CVD are at a higher risk of developing post-operative cardiovascular events. Appropriate screening for this vulnerable population is recommended to prevent the risk of post-operative complications.
评估老年髋部骨折手术患者中预先存在的心血管疾病（CVD）与术后心血管事件风险之间的关联。
我们对至少 65 岁接受手术干预的急性髋部骨折患者进行了一项观察性研究。将预先存在 CVD 的髋部骨折患者与无预先存在 CVD 的患者按年龄、性别、骨折类型和入院年份进行匹配。主要终点是术后心血管事件，患者随访至出院。在调整了年龄、体重指数、骨折至手术时间、预先存在的合并症和 Charlson 合并症指数（CCI）等潜在混杂因素后，使用条件逻辑回归来确定预先存在 CVD 与术后心血管事件之间的关联。
该研究匹配了 858 对存在和不存在预先存在 CVD 的患者。术后心血管事件分别在 40 例和 14 例存在和不存在预先存在 CVD 的患者中发生（每 1000 人分别为 44.6 和 16.3 例）。与无预先存在 CVD 的患者相比，任何预先存在 CVD 的患者发生术后心血管事件的可能性更高，其粗比值比（OR）为 2.857（95%置信区间[CI]，1.554 至 5.251），多变量调整后的 OR 为 2.850（95% CI，1.318 至 7.139）。
在接受髋部骨折手术的老年患者中，预先存在 CVD 的患者发生术后心血管事件的风险更高。建议对这一脆弱人群进行适当的筛查，以预防术后并发症的风险。
