Incidence and 1-Year Outcomes of Perioperative Atrial Arrhythmia in Elderly Adults After Hip Fracture Surgery.
OBJECTIVE
To determine the incidence and 1-year outcomes of an elderly population with perioperative atrial arrhythmia (PAA) within 7 days of hip fracture surgery.


METHODS
Retrospective cohort study.


METHODS
The Rochester Epidemiology Project (REP).


METHODS
Elderly adults consecutive undergoing hip fracture repair from 1988 to 2002 in Olmsted County, Minnesota (N = 1,088, mean age 84.0 ± 7.4, 80.2% female).


METHODS
Baseline clinical variables were analyzed in relation to survival using Cox proportional hazards methods for comparison.


RESULTS
Sixty-one participants (5.6%) developed PAA within the first 7 days. During 1 year of follow-up, 239 (22%) participants died. PAA was associated with greater mortality (45% vs 21%; hazard ratio (HR) = 2.8, 95% confidence interval (CI) = 1.9-4.2). Other mortality risk factors were male sex (HR = 2.0, 95% CI = 1.5-2.6), congestive heart failure (HR = 2.1, 95% CI = 1.7-2.8), chronic renal insufficiency (HR = 2.0, 95% CI = 1.5-2.8), dementia (HR = 2.9, 95% CI = 2.2-3.7), and American Society of Anesthesiologists risk Class III, IV, or V (HR = 3.3, 95% CI = 1.9-5.9).


CONCLUSIONS
Elderly adults undergoing hip fracture surgery who develop PAA within 7 days have significantly higher 1-year mortality than those who do not. Further studies are indicated to determine whether prevention of PAA will reduce mortality in this population.
Division of Cardiovascular Diseases, University of Missouri, Kansas City, Missouri.
Bhanu P
BP
Gupta
Department of Anesthesiology and Perioperative Medicine, Ronald Reagan Medical Center, University of California at Los Angeles, Los Angeles, California.
Rachel C
RC
Steckelberg
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.
Rachel E
RE
Gullerud
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Paul M
PM
Huddleston
Division of Hospital Internal Medicine, Mayo Clinic, Rochester, Minnesota.
Lisa L
LL
Kirkland
Division of Cardiology, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
R Scott
RS
Wright
Division of Hospital Internal Medicine, Mayo Clinic, Rochester, Minnesota.|Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
Jeanne M
JM
Huddleston
D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000453:epidemiology* / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D006325:Heart Atria; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D059035:Perioperative Period; D011183:Postoperative Complications; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors
aged; cardiac arrhythmias; hip fractures; postoperative complication