INFLUENCE OF CARDIAC RISK PREDICTORS ON SURGERY OUTCOME IN ELDERLY WITH HIP FRACTURE

Abstract

ABSTRACT Introduction: Patients with hip fracture are usually older and stress of trauma and surgery may increase cardiac morbidity and mortality. The aim of this study was to compare the influence of cardiac risk factors on surgical outcome in elderly patients with hip fracture. Methods: 120 patients with hip fracture older than 70 years with previously defined high or low per operative cardiac risk according to ACC/AHA guidelines were included and were assigned to two groups of 60 patients: Risk group –patients with high cardiac risk; and NR (non risk) group without or with low cardiac risk. Recipients from the both groups were pain relief with intravenous analgesia: Niflam 2 x 100 mg/iv and Tramadol 50 mg/iv every 8 hours; As an end point of the study were registered the incidence of cardiac events in both groups: cardiac death, myocardial infarction, congestive heart failure, unstable angina and new-onset atrial fibrillation. In all patients was determined pain intensity by using Verbal Descriptive Scale as well as the side effects. Results: Recipients with high cardiac risk has higher incidence of postoperative cardiac events versus patients with low cardiac risk (Risk group 46.6% vs. 15% in NR group) and the same result is with mortality rate (10% in Risk group vs. 0% in NR group). The values of VDS were equal in recipients from both groups. Conclusion: Patients with hip fracture are classified as a high risk patients according the presents of high risk cardiac predictors, and have significantly higher incidence of postoperative cardiac morbidity and mortality.