Background. Although many articles have discussed regarding operative results in patients with hip fractures, few focus on the relationship between these results and cardiac function. We sought to clarify this relationship by evaluating cardiac function preoperatively using echocardiograms and electrocardiograms.
Method. This study involved 162 patients aged 70 years and older who underwent operations for hip fractures in our hospital from April 2006 to December 2008. The patients were divided into two groups: group A (70 cases) consisted of patients with left ventricular ejection fraction (LVEF) values of less than 60% on echocardiograms or electrocardiographic abnormalities, and group B (92 cases) consisted of patients with LVEF values of 60% or higher and no electrocardiographic abnormalities. For each patient, activities of daily living (ADL), pre and postoperative complications, postoperative ambulatory ability, and life prognoses were examined.
Results. The occurrence of postoperative complications was higher in group A (21 cases) than in group B (4 cases) (p < 0.01). At the time of discharge from the hospital, the Barthel Index value (an ADL indicator) for group A (49.5 ± 37.5 points) was significantly lower than that for group B (67.2 ± 34.4 points) (p < 0.05). The percentage of patients who maintained preoperative ambulatory ability was significantly lower for group A (56.9%) than for group B (75.5%) (p < 0.05). Five deaths occurred during hospitalization in group A and 1 occurred in group B, showing a significant difference between the groups (p < 0.01).
Conclusions. Preoperative evaluation of cardiac function is important to obtain a better understanding of the risks of complications and achieve better operative results in patients with hip fractures. Patients with decreased LVEF values on echocardiograms or electrocardiographic abnormalities more careful management before and after operations.
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