title: The effects of preoperative non-invasive cardiac tests on delay to surgery and subsequent mortality in elderly patients with hip fracture.
abstract: OBJECTIVE
  To investigate the effects of preoperative cardiac tests on the surgical treatment plan and subsequent effects on mortality in elderly patients with hip fracture.
  
  
  METHODS
  In this retrospective study, 116 patients aged 60 years or above who underwent hip fracture surgery between 2010-2013 were evaluated. Of the patients with similar preoperative clinical risk factors, 20 patients with additional preoperative cardiac tests such as echocardiography or thalium scintigraphy constituted Group 1, whereas 28 patients without additional cardiac tests constituted Group 2. Statistical analyses were performed using the SPSS 21 statistical package software. Normal distribution of the data was determined by the Shapiro-Wilk test and histography. Intergroup and mortality comparisons were performed by Mann-Whitney U, Yates-corrected chi-square and Fisher's exact tests.
  
  
  RESULTS
  The mean time between fracture and operation was 6 days (range, 4-14) in Group 1, and 2 days (range, 0-3) in Group 2. There was a significant difference in time-to-operation between the groups (p< 0.001). The age and gender distribution of both groups were homomgenous (p= 0.64, p= 1.0). Both groups were comparable in terms of fracture type, treatment, and anesthesia (p= 0.36, p= 0.42, p= 1.0). At the end of 1 year, six (30%) patients in Group 1 and three (10.7%) patients in Group 2 were deceased. Both groups were comparable in terms of mortality (p= 0.137). There was a significant difference between the two groups in terms of complications (p< 0.05).
  
  
  CONCLUSIONS
  Unnecessary cardiac tests in elderly patients with hip fracture led to a delay in their surgery, yet did not change their cardiac treatment plan. This delay in obtaining hip fracture surgery increases complication rates, hospitalization duration, and costs.
authors.affiliation: Department of Orthopaedic, Taksim Training and Research Hospital, Istanbul, Turkey.
authors.forename: Harun
authors.initials: H
authors.lastname: Mutlu
authors.affiliation: Department of Orthopaedic, Istanbul University Istanbul Medical School, Istanbul, Turkey.
authors.forename: Fuat
authors.initials: F
authors.lastname: Bilgili
authors.affiliation: Department of Orthopaedic, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey.
authors.forename: Serhat
authors.initials: S
authors.lastname: Mutlu
authors.affiliation: Department of Orthopaedic, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Karaman
authors.affiliation: Department of Cardiology, Medipol University Medical School, Istanbul, Turkey.
authors.forename: Beytullah
authors.initials: B
authors.lastname: Cakal
authors.affiliation: Department of Orthopaedic, Taksim Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ufuk
authors.initials: U
authors.lastname: Ozkaya
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006334:Heart Function Tests; D006620:Hip Fractures / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011300:Preoperative Care; D012189:Retrospective Studies; D061665:Time-to-Treatment; D014421:Turkey / Q000453:epidemiology
keywords: Cardiac tests; hip fracture; mortality