Myocardial Infarction After Hip Fracture Repair: A Population-Based Study
Article first published online: 30 OCT 2012
© 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 60, Issue 11, pages 2020–2026, November 2012
How to Cite
J Am Geriatr Soc 60:2020–2026, 2012.
- Issue published online: 13 NOV 2012
- Article first published online: 30 OCT 2012
- AHA. Grant Numbers: 03–30103N-04, R01-AR30582
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. Grant Number: 1 KL2 RR024151
- National Center for Research Resources (NCRR)
- National Institutes of Health (NIH)
- NIH Roadmap for Medical Research
- hip fracture;
- myocardial infarction;
- postoperative complications
To quantify the occurrence of myocardial infarction (MI) occurring in the early postoperative period after surgical hip fracture repair and estimate the effect on 1-year mortality.
A population-based, historical cohort study of individuals who underwent surgical repair of a hip fracture that used the computerized medical record linkage system of the Rochester Epidemiology Project.
Academic and community hospitals, outpatient offices, and nursing homes in Olmsted County, Minnesota.
Over the 15-year study period (1988–2002), 1,116 elderly adults underwent surgical repair of a hip fracture.
At the end of the first 7 days after hip fracture repair, participants were classified into one of three groups: clinically verified MI (cv-MI), subclinical myocardial ischemia, and no myocardial ischemia. One-year mortality was compared between these groups. Multivariate models assessed risk factors for early postoperative cv-MI and 1-year mortality.
Within the first 7 days after hip fracture repair, 116 (10.4%) participants experienced cv-MI and 41 (3.7%) subclinical myocardial ischemia. Overall 1-year mortality was 22%, with no difference between those with subclinical myocardial ischemia and those with no myocardial ischemia. One-year mortality for those with cv-MI (35.8%) was significantly higher than for the other two groups. Occurrence of early postoperative cv-MI, male sex, and history of heart failure or dementia were independently associated with greater 1-year mortality, whereas prefracture home residence and preoperative higher hemoglobin were protective.
Rates of early postoperative, cv-MI after hip fracture repair exceed rates after other major orthopedic surgeries and are independently associated with greater 1-year mortality.