The role of preoperative cardiac investigation in emergency hip surgery

Area of Science:

• Geriatric Medicine
• Cardiology
• Orthopedic Surgery

Background:

• Hip fracture treatment requires timely intervention.
• Pre-operative medical optimization versus surgical delay presents a clinical challenge.
• Echocardiography is often perceived to delay hip fracture surgery without significant management changes.

Purpose of the Study:

• To evaluate the impact of pre-operative echocardiography on surgical timing for hip fractures.
• To assess whether echocardiography influences patient management and outcomes in hip fracture cases.

Main Methods:

• Retrospective review of 49 patients who underwent pre-operative echocardiography for hip fracture.
• Comparison with 58 control patients who did not have echocardiography.
• Analysis of time to surgery, medication changes, and need for further cardiac interventions.

Main Results:

• Patients with echocardiography had a significantly longer time to surgery (3.30 days vs. 1.5 days).
• Echocardiography led to medication changes in 51.02% of cases, compared to 6.9% in the control group.
• No significant difference in the need for angiography, bypass, or valvular surgery; similar rates of spinal anesthesia.

Conclusions:

• Pre-operative echocardiography significantly delays surgery for hip fracture patients.
• The delay associated with echocardiography may negatively impact patient outcomes.
• Current echocardiography protocols warrant re-evaluation in the context of expedited hip fracture care.