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Related Concept Videos

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The hip is a ball-and-socket joint that consists of the femoral head articulating with the acetabulum. When combined with the hip ligaments, the hip makes for a very strong and stable joint. But, despite this stability, the hip has considerable motion and is prone to degeneration with wear and tear over time and after injury. Hip pain can affect patients of all ages and can be associated with various intra- and...
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Related Experiment Video

Updated: Jan 20, 2026

Method and Instrumented Fixture for Femoral Fracture Testing in a Sideways Fall-on-the-Hip Position
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Cardiac overscreening hip fracture patients.

S J M Smeets1, B P W van Wunnik2, M Poeze3

  • 1Department of Surgery, Flevoziekenhuis, Hospitaalweg 1, 1315 RA, Almere, The Netherlands. ssmeets@flevoziekenhuis.nl.

Archives of Orthopaedic and Trauma Surgery
|September 1, 2019
PubMed
Summary

Adherence to cardiac screening guidelines for hip fracture patients reduces resource use. However, overscreening delays surgery, increasing mortality risk and complications.

Keywords:
ACC/AHA guidelineCardiac screeningGeriatricHip fracturePreoperative screening

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Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Orthopedic Surgery

Background:

  • Hip fracture patients require careful perioperative assessment.
  • Adherence to American College of Cardiology (ACC) and American Heart Association (AHA) guidelines is crucial for patient outcomes.
  • Current clinical practice for perioperative cardiac assessment in hip fracture patients needs investigation.

Purpose of the Study:

  • To prospectively evaluate adherence to ACC/AHA guidelines for perioperative cardiac assessment in hip fracture patients.
  • To determine the impact of guideline adherence on patient outcomes.
  • To analyze factors influencing preoperative cardiac screening and surgical delay.

Main Methods:

  • Prospective cohort study of 166 hip fracture patients over 3 years.
  • Analysis of preoperative cardiac screening and ACC/AHA guideline adherence.
  • Classification of cardiac risk (low, intermediate, high).
  • Secondary outcomes included surgical delay, complications, and mortality at various time points.

Main Results:

  • 87% of patients received correct preoperative cardiac screening per ACC/AHA guidelines.
  • Overscreening (> 90%) was the primary reason for incorrect screening.
  • Cardiac consultation and overscreening significantly predicted increased surgical delay.
  • High-risk patients had higher in-hospital mortality compared to low-risk patients.
  • Previous cardiac history and surgical delay predicted early mortality; high age and cardiac history predicted late mortality.

Conclusions:

  • Adherence to ACC/AHA guidelines for preoperative cardiac screening in hip fracture patients is linked to reduced preoperative resource utilization.
  • Overscreening contributes to surgical delays, elevating the risk of perioperative complications and early mortality.
  • Optimizing cardiac screening protocols can improve patient outcomes and resource management.