title: Decreased left ventricular (LV) function is associated with hip-fractures.
abstract: BACKGROUND
  Several risk factors for falls and hip-fractures have been recognized, but controversy still exists toward the importance of structural cardiac abnormalities as a potentially modifiable risk factor for recurrent falls. Aim of this study was to determine the association between echocardiographic abnormalities and hip-fractures.
  
  
  METHODS
  Design case-control study within consecutive patients undergoing hip-surgery in an academic hospital.
  
  
  METHODS
  patients with traumatic hip-fractures.
  
  
  METHODS
  patients undergoing planned hip surgery (non-traumatic).
  
  
  METHODS
  age≥50 years, presence of pre-operative echocardiogram.
  
  
  METHODS
  high energy trauma, pathological and/or previous hip-fracture.
  
  
  RESULTS
  echocardiographic abnormalities (ventricular function, atrial enlargement, valve stenosis and/or regurgitation, pulmonary hypertension (pulmonary artery pressure (PAP) ≥35mmHg)). Multivariate logistic regression was performed to calculate odds ratios (OR) and to correct for confounders.
  
  
  RESULTS
  We included 197 patients (141 cases). Mean age was 77 years (SD), 65% female. After adjustment for potential confounders, decreased LV systolic function was associated with hip-fractures (OR 3.2 [95%CI 1.1-9.1]). Increasing severity of LV dysfunction was also associated with hip-fractures (p for trend=0.012).
  
  
  CONCLUSIONS
  In conclusion, patients with traumatic hip-fracture had greater risk of decreased LV function than patients who underwent planned hip-surgery. Possibly, decreased LV function is an underestimated risk factor for injurious falls.
authors.affiliation: Department of Medicine, Section of Geriatric Medicine, Academical Medical Center, Amsterdam, The Netherlands. Electronic address: s.jansen@amc.uva.nl.
authors.forename: Sofie
authors.initials: S
authors.lastname: Jansen
authors.affiliation: Department of Cardiology, Academical Medical Center, Amsterdam, The Netherlands.
authors.forename: Rudolph W
authors.initials: RW
authors.lastname: Koster
authors.affiliation: Department of Cardiology, Academical Medical Center, Amsterdam, The Netherlands.
authors.forename: Frederik J
authors.initials: FJ
authors.lastname: de Lange
authors.affiliation: Trauma Unit, Department of Surgery, Academical Medical Center, Amsterdam, The Netherlands.
authors.forename: J Carel
authors.initials: JC
authors.lastname: Goslings
authors.affiliation: Department of Orthopaedic Surgery, Academical Medical Center, Amsterdam, The Netherlands.
authors.forename: Matthias U
authors.initials: MU
authors.lastname: Schafroth
authors.affiliation: Department of Medicine, Section of Geriatric Medicine, Academical Medical Center, Amsterdam, The Netherlands.
authors.forename: Sophia E
authors.initials: SE
authors.lastname: de Rooij
authors.affiliation: Department of Medicine, Section of Geriatric Medicine, Academical Medical Center, Amsterdam, The Netherlands. Electronic address: n.vandervelde@amc.nl.
authors.forename: Nathalie
authors.initials: N
authors.lastname: van der Velde
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004452:Echocardiography; D005260:Female; D006620:Hip Fractures / Q000150:complications* / Q000601:surgery; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012307:Risk Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology
keywords: Cardiac abnormalities; Echocardiography; Falls; Hip-fracture; LV function