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Preoperative echocardiogram does not increase time to surgery in hip fracture patients with prior percutaneous coronary intervention

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

The purpose of this study was to (1) assess the effect of preoperative echocardiogram on time to surgery and (2) assess the outcomes of patients with a previous percutaneous coronary intervention (PCI).

Methods

Demographic, clinical, quality and cost data were obtained and a validated risk predictive tool (STTGMA) was calculated for each of a consecutive series of hip fracture patients. Comparative analyses of patients who had an echocardiogram prior to surgery or a PCI prior to hospitalization were performed.

Results

Between 2014 and 2020, 2625 patients presented to our institution with a hip fracture. From this cohort 471 patients underwent a preoperative transthoracic echocardiogram (TTE), 30 who had a history of a PCI, and an additional 26 who had a history of PCI but did not undergo a preoperative TTE. Those undergoing a preoperative TTE had similar time (days) to surgery (1.73 vs 1.77, p = 0.86) and 30-day mortality (4% vs 7%, p = 0.545) regardless of PCI history. PCI patients who underwent a preoperative TTE experienced increased rates of 1-year mortality (27% vs 10%, p = 0.007) and major complications (23% vs 12%, p = 0.08) compared to those without a PCI history. PCI patients undergoing a preoperative TTE had a similar time (days) to surgery (1.77 vs 1.48, .p = 0.397) compared to PCI patients without a preoperative TTE. Patients who underwent a preoperative TTE had higher rates of 90-day readmission (31.0% vs 8.0%, p = 0.047) and 1-year mortality (26.7% vs 3.8%, p = 0.029).

Conclusions

Having a preoperative TTE does not affect surgical wait times in hip fracture patients regardless of PCI history, but it may not improve mortality outcomes or reduce postoperative complications in patients with a history of a PCI.

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Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. NYU Grossman School of Medicine, 550 1st Ave, New York, NY, 10016, USA

    Tensae Assefa

  2. NYU Langone Orthopedic Hospital, 301 E 17th St, New York, NY, 10010, USA

    Garrett Esper, Sanjit Konda & Kenneth Egol

  3. NYU Langone Health, 550 1st Ave, New York, NY, 10016, USA

    Salvatore Cavaleri & David Furgiuele

Authors
  1. Tensae Assefa
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  2. Garrett Esper
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  3. Salvatore Cavaleri
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  4. David Furgiuele
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  5. Sanjit Konda
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  6. Kenneth Egol
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Corresponding author

Correspondence to Kenneth Egol.

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The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Human Investigation Committee (IRB) of NYU Langone approved this study.

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Due to the approved IRB, informed consent was not required as study was retrospective in nature and information was anonymized.

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Assefa, T., Esper, G., Cavaleri, S. et al. Preoperative echocardiogram does not increase time to surgery in hip fracture patients with prior percutaneous coronary intervention. Eur J Orthop Surg Traumatol 33, 1013–1022 (2023). https://doi.org/10.1007/s00590-022-03245-8

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  • DOI: https://doi.org/10.1007/s00590-022-03245-8

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