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Published on: May 21, 2017
Aortic stenosis in elderly hip fractured patients
Abraham Adunsky1, Alexander Kaplan, Marina Arad
1Department of Geriatric Medicine and the Orthogeriatric Unit, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52561, Israel. adunger1@sheba.health.gov.il
Archives of Gerontology and Geriatrics
|July 14, 2007
Summary
Elderly patients with aortic stenosis (AS) undergoing hip fracture surgery had higher in-hospital complications and mortality. However, one-year survival rates were similar to those without AS, suggesting careful management is key.
Area of Science:
- Geriatric Medicine
- Cardiology
- Orthopedic Surgery
Background:
- Elderly patients frequently present with both aortic stenosis (AS) and hip fractures, posing complex management challenges.
- The decision for surgical intervention in these high-risk patients requires careful consideration of potential outcomes.
- Understanding the characteristics and outcomes of elderly hip fracture patients with AS is crucial for optimizing care.
Purpose of the Study:
- To examine the characteristics of elderly patients with hip fractures and co-existing aortic stenosis.
- To compare the management and outcomes of hip fracture patients with and without AS.
- To identify factors influencing in-hospital and one-year mortality in this patient cohort.
Main Methods:
- Retrospective chart review of patients admitted for hip fractures over a 10-year period at a tertiary hospital.
- Inclusion of 62 elderly patients with confirmed aortic stenosis (AS) and hip fractures.
- Comparison group comprised 100 hip fracture patients without AS, analyzing demographic, clinical, and echocardiographic data.
Main Results:
- Patients with AS were older (mean age 85.9 years) and underwent surgery more frequently (91%).
- The AS group experienced higher rates of major in-hospital complications (8% vs. 3.6%) and in-hospital mortality (6.5% vs. 3.3%) compared to controls.
- One-year mortality rates were similar between the AS (17.7%) and non-AS (16.1%) groups.
Conclusions:
- Surgery for hip fractures in elderly patients with aortic stenosis is associated with increased in-hospital morbidity and mortality.
- Despite higher acute risks, one-year survival rates do not significantly differ between AS and non-AS patients.
- Further research into optimized medical and surgical management strategies is warranted to improve outcomes for these complex patients.
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