Preoperative cardiac risk assessment in geriatric patients with hip fractures: an orthopedic surgeons’ perspective

Hip fracture is one of the most common orthopedic conditions and is associated with significant morbidity and mortality. With a progressively aging population, the annual incidence of hip fracture is expected to increase substantially. Emerging evidence suggests that early surgery (48 h) has been co...

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Bibliographic Details
Published in:Osteoporosis international 2010-12, Vol.21 (Suppl 4), p.587-591
Main Authors: Siu, C. W., Sun, N. C. H., Lau, T. W., Yiu, K. H., Leung, F., Tse, H. F.
Format: Article
Language:English
Subjects:
Aged
Cardiovascular system
Endocrinology
Fractures
Health risk assessment
Heart Diseases - complications
Heart Diseases - diagnosis
Hip Fractures - surgery
Hip joint
Humans
Joint surgery
Medicine
Medicine & Public Health
Older people
Orthopedics
Osteoporotic Fractures - surgery
Postoperative Complications - prevention & control
Preoperative Care - methods
Review
Rheumatology
Risk Assessment - methods
Triage - methods
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Summary:Hip fracture is one of the most common orthopedic conditions and is associated with significant morbidity and mortality. With a progressively aging population, the annual incidence of hip fracture is expected to increase substantially. Emerging evidence suggests that early surgery (48 h) has been consistently demonstrated to be associated with an increased risk of 30-day and 1-year mortality. Nonetheless, early surgery necessitates a shorter time for preoperative medical preparation, in particular cardiac assessment. Patients who undergo emergent orthopedic surgery are therefore at greater risk of perioperative cardiac events than those who undergo elective surgery. In addition, the prompt triage system for preoperative cardiac assessment not only identifies patients at high risk of perioperative cardiac complications but also reduces unnecessary cardiac consultations for low-risk patients. We review the current recommendations for preoperative cardiac assessment adapted for patients with hip fracture and describe our current triage system for preoperative cardiac consultation.
ISSN:0937-941X
1433-2965
DOI:10.1007/s00198-010-1393-0