title: Myocardial infarction after hip fracture repair: a population-based study.
abstract: OBJECTIVE
  To quantify the occurrence of myocardial infarction (MI) occurring in the early postoperative period after surgical hip fracture repair and estimate the effect on 1-year mortality.
  
  
  METHODS
  A population-based, historical cohort study of individuals who underwent surgical repair of a hip fracture that used the computerized medical record linkage system of the Rochester Epidemiology Project.
  
  
  METHODS
  Academic and community hospitals, outpatient offices, and nursing homes in Olmsted County, Minnesota.
  
  
  METHODS
  Over the 15-year study period (1988-2002), 1,116 elderly adults underwent surgical repair of a hip fracture.
  
  
  METHODS
  At the end of the first 7 days after hip fracture repair, participants were classified into one of three groups: clinically verified MI (cv-MI), subclinical myocardial ischemia, and no myocardial ischemia. One-year mortality was compared between these groups. Multivariate models assessed risk factors for early postoperative cv-MI and 1-year mortality.
  
  
  RESULTS
  Within the first 7 days after hip fracture repair, 116 (10.4%) participants experienced cv-MI and 41 (3.7%) subclinical myocardial ischemia. Overall 1-year mortality was 22%, with no difference between those with subclinical myocardial ischemia and those with no myocardial ischemia. One-year mortality for those with cv-MI (35.8%) was significantly higher than for the other two groups. Occurrence of early postoperative cv-MI, male sex, and history of heart failure or dementia were independently associated with greater 1-year mortality, whereas prefracture home residence and preoperative higher hemoglobin were protective.
  
  
  CONCLUSIONS
  Rates of early postoperative, cv-MI after hip fracture repair exceed rates after other major orthopedic surgeries and are independently associated with greater 1-year mortality.
authors.affiliation: Divisions of Hospital Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA. huddleston.jeanne@mayo.edu
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Huddleston
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Gullerud
authors.forename: Fantley
authors.initials: F
authors.lastname: Smither
authors.forename: Paul M
authors.initials: PM
authors.lastname: Huddleston
authors.forename: Dirk R
authors.initials: DR
authors.lastname: Larson
authors.forename: Michael P
authors.initials: MP
authors.lastname: Phy
authors.forename: L Joseph
authors.initials: LJ
authors.lastname: Melton
authors.forename: Veronique L
authors.initials: VL
authors.lastname: Roger
mesh_terms: D000369:Aged, 80 and over; D005260:Female; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality; D011183:Postoperative Complications / Q000453:epidemiology*; D015996:Survival Rate