Chao Ting-Cheng, Lee Hsin-Pai, Wu Jung-Chou, Hsu Chien-Jen
Department of Orthopaedics, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan.
Department of Orthopaedic Surgery, Ping-Tung Christian Hospital, Pingtung 90059, Taiwan.
J Clin Med. 2023 Aug 14;12(16):5276. doi: 10.3390/jcm12165276.
Perioperative complications, particularly cardiac events, compromised surgical outcomes for geriatric patients. This retrospective study intended to investigate the occurrence and subsequent impact of cardiac events for geriatric patients undergoing hip fracture surgeries. We collected 607 patients undergoing hip fracture surgeries from January 2017 to December 2022 that received transthoracic echocardiography (TTE) pre-operatively to screen for cardiac abnormalities. Except for demographic characteristics, the researchers recorded fracture type, surgical method, American Society of Anesthesiologists (ASA) class, anesthesia type, perioperative cardiac events, and in-hospital mortality. Statistical analysis was performed using SPSS 22.0 statistics software. Throughout the whole course of the study, 16 postoperative cardiac events occurred. The cardiac events included ten arrhythmias, three acute myocardial infarctions, two heart failures, and one sudden death. Notably, 12 of 16 patients with cardiac events presented with abnormal findings on TTE, except 15 of them had a history of cardiac disease. This study disclosed 93.7% of cardiac events developed in patients with a history of cardiovascular disease. Among patients that experienced cardiac events, 75% of patients had abnormal echocardiographic findings. Pre-operative transthoracic echocardiography deserves a recommendation for geriatric patients with histories of cardiac diseases undergoing hip fracture surgeries to detect the risk of developing cardiac events earlier.
围手术期并发症,尤其是心脏事件,会影响老年患者的手术结局。这项回顾性研究旨在调查老年髋部骨折手术患者心脏事件的发生情况及其后续影响。我们收集了2017年1月至2022年12月期间接受髋部骨折手术的607例患者,这些患者术前接受了经胸超声心动图(TTE)检查以筛查心脏异常。除人口统计学特征外,研究人员记录了骨折类型、手术方法、美国麻醉医师协会(ASA)分级、麻醉类型、围手术期心脏事件和院内死亡率。使用SPSS 22.0统计软件进行统计分析。在整个研究过程中,发生了16例术后心脏事件。心脏事件包括10例心律失常、3例急性心肌梗死、2例心力衰竭和1例猝死。值得注意的是,16例发生心脏事件的患者中有12例TTE检查结果异常,其中15例有心脏病史。本研究显示,93.7%的心脏事件发生在有心血管疾病史的患者中。在发生心脏事件的患者中,75%的患者超声心动图检查结果异常。对于有心脏病史的老年髋部骨折手术患者,术前经胸超声心动图有助于更早发现发生心脏事件的风险。