Document Detail

The role of routine pre-operative bedside echocardiography in detecting aortic stenosis in patients with a hip fracture.
MedLine Citation:
PMID:  22023667     Owner:  NLM     Status:  MEDLINE    
The prevalence and severity of aortic stenosis in unselected patients admitted with a hip fracture is unknown. Derriford Hospital operates a routine weekday, pre-operative, targeted bedside echocardiography examination on all patients admitted with a hip fracture. We carried out a prospective service evaluation for 13 months from October 2007 on all 501 admissions, of which 374 (75%) underwent pre-operative echocardiography. Of those patients investigated, 8 (2%) had severe, 24 (6%) moderate and 113 (30%) had mild aortic stenosis or aortic sclerosis. Eighty-seven of 278 (31%) patients with no murmur detected clinically on admission had aortic stenosis on echocardiography and of the 96 patients in whom a murmur was heard pre-operatively, 30 (31%) had a normal echocardiogram. Detection of a murmur does not necessarily reflect the presence of underling aortic valve disease. However, if a murmur is heard then the likelihood of the lesion's being moderate or severe aortic stenosis is increased (OR 8.5; 95% CI 3.8-19.5). Forty-four (12%) of our unselected patients with fractured femur had either moderate or severe aortic stenosis (with or without moderate or severe left ventricular failure), or mild stenosis with moderately or severely impaired left ventricular function.
S J Loxdale; J R Sneyd; A Donovan; G Werrett; D J Viira
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Publication Detail:
Type:  Journal Article     Date:  2011-10-24
Journal Detail:
Title:  Anaesthesia     Volume:  67     ISSN:  1365-2044     ISO Abbreviation:  Anaesthesia     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-12-13     Completed Date:  2012-01-23     Revised Date:  2012-07-31    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  England    
Other Details:
Languages:  eng     Pagination:  51-4     Citation Subset:  AIM; IM    
Copyright Information:
Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.
Department of Anaesthesia, Derriford Hospital, Plymouth, UK.
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MeSH Terms
Aortic Valve Stenosis / complications,  epidemiology,  ultrasonography*
Echocardiography / methods*
Great Britain / epidemiology
Heart Murmurs / ultrasonography
Hip Fractures / complications,  epidemiology,  ultrasonography*
Logistic Models
Middle Aged
Point-of-Care Systems*
Prospective Studies
Ventricular Dysfunction, Left / etiology,  ultrasonography
Young Adult
Comment In:
Anaesthesia. 2012 Jul;67(7):793-4; author reply 795-6   [PMID:  22670736 ]
Anaesthesia. 2012 Jul;67(7):795; author reply 795-6   [PMID:  22670739 ]
Anaesthesia. 2012 Jul;67(7):794; author reply 795-6   [PMID:  22670737 ]

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