| Clinical presentation and outcome of perioperative myocardial infarction in the very elderly following hip fracture surgery. | |
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MedLine Citation:
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PMID: 22956471 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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. Journal of Hospital Medicine 2012; © 2012 Society of Hospital Medicine. |
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Authors:
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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:
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Type: JOURNAL ARTICLE Date: 2012-9-6 |
Journal Detail:
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Title: Journal of hospital medicine : an official publication of the Society of Hospital Medicine Volume: - ISSN: 1553-5606 ISO Abbreviation: J Hosp Med Publication Date: 2012 Sep |
Date Detail:
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Created Date: 2012-9-7 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101271025 Medline TA: J Hosp Med Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Society of Hospital Medicine. |
Affiliation:
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Division of Hospital Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota. gupta.bhanu@mayo.edu. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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