Related Experiment Video

Updated: Apr 7, 2026

The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
09:51

The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve

Published on: September 7, 2022

3.8K

Adherence to Preoperative Cardiac Clearance Guidelines in Hip Fracture Patients

Andrea Stitgen1, Kim Poludnianyk, Elizabeth Dulaney-Cripe

  • 1Department of Orthopaedic Surgery, Boonshoft School of Medicine, Wright State University, Dayton, OH.

Journal of Orthopaedic Trauma
|July 14, 2015
PubMed

Insights

Preoperative cardiac consultations are often unnecessary for hip fracture patients, leading to delayed surgery and longer hospital stays. Adhering to guidelines can improve care efficiency.

Area of Science:

  • Cardiology
  • Trauma Surgery
  • Healthcare Management

Background:

  • Preoperative cardiac evaluation is crucial for patients undergoing surgery.
  • Adherence to established guidelines (ACC/AHA) ensures appropriate cardiac consultations.
  • Unnecessary consultations can impact patient care pathways and resource utilization.

Purpose of the Study:

  • To evaluate adherence to American College of Cardiology (ACC) and American Heart Association (AHA) guidelines for preoperative cardiac consultations in hip fracture patients.
  • To determine the impact of unnecessary cardiac consultations on surgical delays and hospital length of stay.

Main Methods:

  • Retrospective review of 266 hip fracture patients (aged ≥65) admitted to a Level 1 trauma center over two years.
  • Analysis of preoperative cardiac consultation appropriateness based on ACC/AHA guidelines.
  • Comparison of time to surgery and hospital length of stay between patients with and without guideline-concordant consultations.

Main Results:

  • 21% of hip fracture patients received preoperative cardiac consultations, but only 29% met ACC/AHA guidelines.
  • Unnecessary cardiac consultations were associated with significantly longer time to surgery (43.9 vs. 23.1 hours) and increased hospital length of stay (7.9 vs. 5.3 days).
  • No significant differences were observed in postoperative complications or patient disposition.

Conclusions:

  • Preoperative cardiac consultations are frequently overused in hip fracture patients, leading to care delays and extended hospital stays.
  • Stricter adherence to ACC/AHA guidelines for cardiac consultations can optimize surgical timing and reduce hospital resource utilization.
  • Implementing guideline-based practices can improve efficiency without compromising patient safety or outcomes.
Abstract

Related Concept Videos

Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
432
Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
587
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
587
Cardiac Catheterization IV: Nursing Management01:26

Cardiac Catheterization IV: Nursing Management

Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
1.1K
Cardiac Catheterization I: Pre-Procedure Overview01:28

Cardiac Catheterization I: Pre-Procedure Overview

Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
2.7K
Pre-Procedural Guidelines for Assessing Blood Pressure01:10

Pre-Procedural Guidelines for Assessing Blood Pressure

Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the...
958