Document Detail


Clinical presentation and outcome of perioperative myocardial infarction in the very elderly following hip fracture surgery.
MedLine Citation:
PMID:  22956471     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patterns of clinical symptoms and outcomes of perioperative myocardial infarction (PMI) in elderly patients after hip fracture repair surgery are not well defined.
METHODS: A retrospective 1:2 case-control study in a cohort of 1212 elderly patients undergoing hip fracture surgery from 1988 to 2002 in Olmsted County, Minnesota.
RESULTS: The mean age was 85.3 ± 7.4 years; 76% female. PMI occurred in 167 (13.8%) patients within 7 days, of which 153 (92%) occurred in first 48 hours; 75% of patients were asymptomatic. Among patients with PMI, in-hospital mortality was 14.4%, 30-day mortality was 29 (17.4%), and 1-year mortality was 66 (39.5%). PMI was associated with a higher inpatient mortality rate (odds ratio [OR], 15.1; confidence interval [CI], 4.6-48.8), 30-day mortality (hazard ratio [HR], 4.3; CI, 2.1-8.9), and 1-year mortality (HR, 1.9; CI, 1.4-2.7).
CONCLUSION: Elderly patients, after hip fracture surgery, have a higher incidence of PMI and mortality than what guidelines indicate. The majority of elderly patients with PMI did not experience ischemic symptoms and required cardiac biomarkers for diagnosis. The results of our study support the measurement of troponin in postoperative elderly patients for the diagnosis of PMI, in order to implement in-hospital preventive strategies to reduce PMI-associated mortality.
Authors:
Bhanu P Gupta; Jeanne M Huddleston; Lisa L Kirkland; Paul M Huddleston; Dirk R Larson; Rachel E Gullerud; M Caroline Burton; Charanjit S Rihal; R Scott Wright
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-09-06
Journal Detail:
Title:  Journal of hospital medicine : an official publication of the Society of Hospital Medicine     Volume:  7     ISSN:  1553-5606     ISO Abbreviation:  J Hosp Med     Publication Date:    2012 Nov-Dec
Date Detail:
Created Date:  2012-12-05     Completed Date:  2013-05-21     Revised Date:  2013-11-14    
Medline Journal Info:
Nlm Unique ID:  101271025     Medline TA:  J Hosp Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  713-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Society of Hospital Medicine.
Affiliation:
Division of Hospital Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA. gupta.bhanu@mayo.edu
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Biological Markers
Case-Control Studies
Creatine Kinase, MB Form / blood
Female
Hip Fractures / epidemiology*,  mortality,  surgery*
Hospital Mortality
Humans
Male
Myocardial Infarction / blood,  epidemiology*,  mortality
Postoperative Complications / epidemiology*,  mortality
Retrospective Studies
Sex Factors
Time Factors
Troponin / blood
Grant Support
ID/Acronym/Agency:
R01 AG034676/AG/NIA NIH HHS; R01-AR30582/AR/NIAMS NIH HHS; UL1 RR024150/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Troponin; EC 2.7.3.2/Creatine Kinase, MB Form
Comments/Corrections

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