Impact of echocardiography on one-month and one-year mortality of intertrochanteric fracture patients

Abstract

Objective: The aim of this study was to analyze the effects of preoperative echocardiography on patientsurvival, timing of surgery in length of hospital stay in patients who will undergo hip nailing for anintertrochanteric fracture.Methods: The clinical records of the patients who were admitted to a tertiary university hospital with anintertrochanteric femur fracture were retrospectively analyzed. The age, gender, American Society ofAnesthesiologists (ASA) score, days to surgery, total hospital stay, cardiac drug prescription/modiŞcation,cardiac intervention and presence of an echocardiography assessment including detailedŞndings werereviewed. Mortality data were accessed from the national civil registration system.Results: 181 (110 women and 71 men; mean age 81 (44e98)) cases were studied whom 65 underwentpre-operative echocardiography. Time to surgery and total hospital stay was 2 days longer at transthoracic echocardiography (TTE) group (p< 0.001). At one month control group survival rate was 93.1%on contrary it was 75.4% at TTE group. One-year survival rates were 77.3% and 55.1% respectively.Likewise mean expected survival time was 21.6± 1.03 months for control group and 15.12 ± 1.64 monthsfor TTE group (p< 0.001). Only increased left ventricular end diastolic diameter (LVEDD) was showed tobe associated with increasing one-year mortality with a hazard ratio of 10.78 (2.572e45.19) at multivariate model.Conclusion: CardiacŞndings and requisite for preoperative TTE and increased LVEDD is a strong predictorfor mortality. TTE signiŞcantly lengthens the time to surgery. Also LVEDD measurement can be easilyperformed in the bedside which we believe would save time and reduce mortality.Level of evidence: Level III Diagnostic study.