Mortality following hip fracture surgery in patients with recent myocardial infarction.
BACKGROUND
In an elective setting, surgery is best avoided for at least 6 months following myocardial infarction. However, in the presence of a femoral neck fracture, this would most probably lead to significant complications in relation to prolonged immobilisation. There is no published mortality data for patients undergoing surgery for hip fracture following a recent myocardial infarction. The aim of this retrospective study was to assess the mortality of hip fracture patients with a recent myocardial infarction that have undergone surgery at our institution.


METHODS
Between January 2003 and October 2005, 2270 patients were admitted to our unit with a proximal femoral fracture. Of these, 11 patients were found to have a recent myocardial infarction.


RESULTS
Of these 11 patients, 8 were female. The average age was 78.2 years (range, 59-90 years). Average delay from the time of infarction to operation was 11.2 days (range, 3-23 days). Mortality at 1 and 6 months was 45.4% and 63.5%, respectively.


CONCLUSIONS
This is much higher than the overall reported mortality following proximal femur fracture. This information may be useful when planning future peri-operative care and discussing overall prognosis with patients and their relatives.
Komarasamy
Baskaran
B
Department of Orthopaedics, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK. baskaran.komarasamy@gmail.com
Forster
Mark C
MC
Esler
Colin N
CN
Harper
William M
WM
Hall
Andrew P
AP
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia / Q000379:methods; D005260:Female; D005265:Femoral Neck Fractures / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality*; D015996:Survival Rate
D000319:Adrenergic beta-Antagonists; D005343:Fibrinolytic Agents
BMJ. 1993 Nov 13;307(6914):1248-50
8166806
Clin Cardiol. 2000 Nov;23(11):831-6
11097130
BMJ. 1997 Oct 11;315(7113):909-12
9361539
J Bone Joint Surg Br. 1996 Jan;78(1):115-8
8898140
J Bone Joint Surg Br. 1992 Mar;74(2):199-202
1544951
Cochrane Database Syst Rev. 2000;(2):CD000337
10796345
J Bone Joint Surg Br. 1989 Aug;71(4):619-23
2670950
Anesthesiology. 1983 Dec;59(6):499-505
6650905
Injury. 2002 Jan;33(1):13-7
11879826
Br J Anaesth. 2005 Jan;94(1):24-9
15516350
J Bone Joint Surg Br. 2001 Apr;83(3):414-8
11341430
BMJ. 2005 Dec 10;331(7529):1374
16299013
J Bone Joint Surg Br. 1992 Mar;74(2):203-5
1544952
N Engl J Med. 1999 Jul 22;341(4):217-25
10413733
BMJ. 1995 Apr 8;310(6984):904-8
7719180
N Engl J Med. 1993 Sep 2;329(10):673-82
8204123
Br J Anaesth. 2002 Jan;88(1):65-71
11881887
Cardiology. 1998 Mar;89(3):216-21
9570437