Preoperative High-Sensitivity Troponin and Risk of In-Hospital Mortality and Cardiac Events after Hip Fracture...

Area of Science:

• Cardiology
• Geriatric Medicine
• Trauma Surgery

Background:

• Hip fracture surgery poses significant risks for cardiac events and mortality.
• Preoperative cardiac risk assessment is crucial for optimizing patient outcomes.
• High-sensitivity cardiac troponin (hs-cTn) is a sensitive biomarker for myocardial injury.

Purpose of the Study:

• To determine if elevated preoperative hs-cTn predicts in-hospital cardiac events and mortality after hip fracture surgery.
• To investigate whether surgical delay influences the relationship between hs-cTn and adverse outcomes.
• To identify specific hs-cTn thresholds associated with increased risk.

Main Methods:

• Retrospective cohort study of adult patients undergoing hip fracture surgery with preoperative hs-cTn measurements.
• Patients were categorized by hs-cTn levels: normal (<30 ng/L), elevated (30-100 ng/L), and significantly elevated (>100 ng/L).
• Surgical delay was analyzed in categories: <24 hours, 24-48 hours, and >48 hours.

Main Results:

• A total of 510 patients were included; 6.9% experienced the composite outcome of cardiac event or mortality.
• Significantly elevated hs-cTn (>100 ng/L) was associated with a 35.7% composite outcome rate (p < 0.001).
• Adjusted models showed elevated hs-cTn (OR 4.4) and significantly elevated hs-cTn (OR 16.1) were independently associated with increased odds of the composite outcome.

Conclusions:

• Preoperative hs-cTn elevation is an independent predictor of in-hospital cardiac events and mortality following hip fracture surgery.
• hs-cTn levels >100 ng/L identify patients at the highest risk, irrespective of surgical delay.
• These findings support the use of hs-cTn for risk stratification in hip fracture patients.