title: The role of preoperative cardiac investigation in emergency hip surgery.
abstract: BACKGROUND
  Given the well recognized imperative to treat hip fractures as expeditiously as possible there can arise uncertainty regarding the balance between pre-operative medical optimization and delay of surgery. Echocardiography is often felt to considerably delay surgery with limited change to patient management.
  
  
  METHODS
  We retrospectively reviewed forty-nine consecutive patients who had echocardiography prior to surgery for hip fracture and compared them to fifty-eight patients who did not have echocardiography.
  
  
  RESULTS
  We found that those who had echocardiography were more likely to have medication changes (51.02% vs. 6.9%) but were unlikely to require angiography, bypass or valvular surgery prior to fracture fixation. Those undergoing echo had a longer time to surgery-3.30 days (SD=2.49) while those in the control group waited 1.5 days (SD=1.29), (p=0.005). Rates of spinal anaesthesia were similar in both groups.
  
  
  CONCLUSIONS
  We feel that these results confirm the theory that echocardiography, as currently provided, significantly delays surgery for hip fracture and that this may negatively affect patient outcomes.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland. svenerwin@hotmail.com
authors.forename: Sven
authors.initials: S
authors.lastname: O'hEireamhoin
authors.forename: Thomas
authors.initials: T
authors.lastname: Beyer
authors.forename: Motaz
authors.initials: M
authors.lastname: Ahmed
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Mulhall
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000175:diagnosis*; D016022:Case-Control Studies; D004452:Echocardiography; D004638:Emergency Treatment; D005260:Female; D006620:Hip Fractures / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome