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Patients of surgical operation of femoral neck fracture are undergoing at risk for heart failure and cardiac mortality. The objective of our work is to identify predictors of heart failure and cardiac mortality in surgical patients of femoral neck fracture.
During the same hospital stay, the Surgery of femoral neck fracture Registry (932 operations from January 2003 through December 2013) was identified that 9 patients developed in whom had heart failure. The data were analyzed regarding preoperative cardiac disease and surgical and anesthetic factors to study association with heart failure and cardiac death according to gender and patient age.
Univariable analysis was used in the following predictors of heart failure were identified: general anesthesia (P = 0.01), preoperative history of coronary artery disease (P = 0.001), valvular disease (P = 0.03), preoperative treatment with beta-blockers (P = 0.05). 9 patients were in heart failure, during the same hospital stay there were 22.2% died of cardiac cause. These factors increased the odds ratios for cardiac death: age (P = 0.05), type of surgery (P = 0.001), lower intraoperative diastolic blood pressure (P = 0.001), new intraoperative ST-T changes (P = 0.01). By using multivariable analysis revealed preoperative definitive diagnosis of coronary artery disease (P = 0.03) and significant valvular disease (P = 0.05) were associated with increased risk of heart failure.
Patients of femoral neck fracture who undergo surgery had high cardiac mortality rate. The heart failure was also high. Poor preoperative cardiac functional status (lower ejection fraction, diagnosis of coronary artery disease) are the factors that determine perioperative cardiac morbidity and mortality rates.