Risk factors for and prognosis of postoperative cardiac events in older patients with hip fractures: a retrospective cohort study
Abstract Background Postoperative cardiac events (PCEs) are life threatening in older patients undergoing hip fracture surgery. This study aimed to investigate the risk factors for PCEs in these patients and to evaluate the impact of PCEs on all-cause mortality after surgery. Methods A retrospective...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-08-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-025-06175-3 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849764237742702592 |
|---|---|
| author | Xuejun Li Meixuan Wan Shuaihao Zhang Yuanming He Daojing Qiu Xiaowei Wang Zhi Liu Xiaobin Chen Chunhua Xi |
| author_facet | Xuejun Li Meixuan Wan Shuaihao Zhang Yuanming He Daojing Qiu Xiaowei Wang Zhi Liu Xiaobin Chen Chunhua Xi |
| author_sort | Xuejun Li |
| collection | DOAJ |
| description | Abstract Background Postoperative cardiac events (PCEs) are life threatening in older patients undergoing hip fracture surgery. This study aimed to investigate the risk factors for PCEs in these patients and to evaluate the impact of PCEs on all-cause mortality after surgery. Methods A retrospective review was performed of consecutive patients who underwent surgery for hip fractures at the Seventh Medical Center, Chinese PLA General Hospital, from January 2012 to December 2020. The patients were divided into a PCE group and a non-PCE group according to whether they experienced PCEs. Univariate and multivariate logistic regression analyses were employed to investigate the independent risk factors for PCEs. Kaplan‒Meier curves and log-rank tests were used to compare the cumulative mortality between the two groups, and a Cox proportional hazards regression model was used to estimate risk factors for mortality. Results We recruited 1718 patients, 169 of whom (9.8%) had experienced PCEs. Acute heart failure (66.9%, 113/169) was the most common PCE, followed by major arrhythmia (18.9%, 32/169) and acute coronary syndrome (14.2%, 24/169). Age ≥ 80 years (OR = 1.92, 95% CI = 1.29–2.91), male sex (OR = 1.55, 95% CI = 1.09–2.20), a history of arrhythmia (OR = 1.65, 95% CI = 1.07–2.48), preoperative deep vein thrombosis (DVT) (OR = 1.89, 95% CI = 1.00–3.43), a higher CCI score (OR = 2.12, 95% CI = 1.43–3.10) and an ASA classification of III or IV (OR = 1.80, 95% CI = 1.23–2.67) were independent risk factors for PCEs. Patients with PCEs had increased cumulative mortality within 1 year (P < 0.001), and PCEs were associated with 30-day mortality (adjusted HR = 2.05, 95% CI = 1.09–3.65). Conclusions PCEs are not uncommon after hip fracture surgery, and may affect mortality in the early postoperative period. Patients with advanced age, male sex, a history of arrhythmia, preoperative DVT, and a higher CCI score and ASA classification are more likely to develop PCEs. Strengthening perioperative care should be considered to avoid potential PCEs in patients with the above risk factors. |
| format | Article |
| id | doaj-art-e35603b688864eef9902ea7c027b129f |
| institution | DOAJ |
| issn | 1749-799X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj-art-e35603b688864eef9902ea7c027b129f2025-08-20T03:05:10ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-08-0120111210.1186/s13018-025-06175-3Risk factors for and prognosis of postoperative cardiac events in older patients with hip fractures: a retrospective cohort studyXuejun Li0Meixuan Wan1Shuaihao Zhang2Yuanming He3Daojing Qiu4Xiaowei Wang5Zhi Liu6Xiaobin Chen7Chunhua Xi8Department of Orthopedics, Beijing Tongren Hospital, Capital Medical UniversityDepartment of Anesthesiology, Beijing Tongren Hospital, Capital Medical UniversityDepartment of Orthopedics, Beijing Tongren Hospital, Capital Medical UniversityDepartment of Orthopedics, Beijing Tongren Hospital, Capital Medical UniversityDepartment of Orthopedics, Beijing Tongren Hospital, Capital Medical UniversityDepartment of Orthopedics, The Seventh Medical Center, Chinese PLA General HospitalDepartment of Orthopedics, The Seventh Medical Center, Chinese PLA General HospitalDepartment of Orthopedics, Beijing Tongren Hospital, Capital Medical UniversityDepartment of Anesthesiology, Beijing Tongren Hospital, Capital Medical UniversityAbstract Background Postoperative cardiac events (PCEs) are life threatening in older patients undergoing hip fracture surgery. This study aimed to investigate the risk factors for PCEs in these patients and to evaluate the impact of PCEs on all-cause mortality after surgery. Methods A retrospective review was performed of consecutive patients who underwent surgery for hip fractures at the Seventh Medical Center, Chinese PLA General Hospital, from January 2012 to December 2020. The patients were divided into a PCE group and a non-PCE group according to whether they experienced PCEs. Univariate and multivariate logistic regression analyses were employed to investigate the independent risk factors for PCEs. Kaplan‒Meier curves and log-rank tests were used to compare the cumulative mortality between the two groups, and a Cox proportional hazards regression model was used to estimate risk factors for mortality. Results We recruited 1718 patients, 169 of whom (9.8%) had experienced PCEs. Acute heart failure (66.9%, 113/169) was the most common PCE, followed by major arrhythmia (18.9%, 32/169) and acute coronary syndrome (14.2%, 24/169). Age ≥ 80 years (OR = 1.92, 95% CI = 1.29–2.91), male sex (OR = 1.55, 95% CI = 1.09–2.20), a history of arrhythmia (OR = 1.65, 95% CI = 1.07–2.48), preoperative deep vein thrombosis (DVT) (OR = 1.89, 95% CI = 1.00–3.43), a higher CCI score (OR = 2.12, 95% CI = 1.43–3.10) and an ASA classification of III or IV (OR = 1.80, 95% CI = 1.23–2.67) were independent risk factors for PCEs. Patients with PCEs had increased cumulative mortality within 1 year (P < 0.001), and PCEs were associated with 30-day mortality (adjusted HR = 2.05, 95% CI = 1.09–3.65). Conclusions PCEs are not uncommon after hip fracture surgery, and may affect mortality in the early postoperative period. Patients with advanced age, male sex, a history of arrhythmia, preoperative DVT, and a higher CCI score and ASA classification are more likely to develop PCEs. Strengthening perioperative care should be considered to avoid potential PCEs in patients with the above risk factors.https://doi.org/10.1186/s13018-025-06175-3Hip fractureElderlyCardiac eventsPostoperativeRisk factorMortality |
| spellingShingle | Xuejun Li Meixuan Wan Shuaihao Zhang Yuanming He Daojing Qiu Xiaowei Wang Zhi Liu Xiaobin Chen Chunhua Xi Risk factors for and prognosis of postoperative cardiac events in older patients with hip fractures: a retrospective cohort study Journal of Orthopaedic Surgery and Research Hip fracture Elderly Cardiac events Postoperative Risk factor Mortality |
| title | Risk factors for and prognosis of postoperative cardiac events in older patients with hip fractures: a retrospective cohort study |
| title_full | Risk factors for and prognosis of postoperative cardiac events in older patients with hip fractures: a retrospective cohort study |
| title_fullStr | Risk factors for and prognosis of postoperative cardiac events in older patients with hip fractures: a retrospective cohort study |
| title_full_unstemmed | Risk factors for and prognosis of postoperative cardiac events in older patients with hip fractures: a retrospective cohort study |
| title_short | Risk factors for and prognosis of postoperative cardiac events in older patients with hip fractures: a retrospective cohort study |
| title_sort | risk factors for and prognosis of postoperative cardiac events in older patients with hip fractures a retrospective cohort study |
| topic | Hip fracture Elderly Cardiac events Postoperative Risk factor Mortality |
| url | https://doi.org/10.1186/s13018-025-06175-3 |
| work_keys_str_mv | AT xuejunli riskfactorsforandprognosisofpostoperativecardiaceventsinolderpatientswithhipfracturesaretrospectivecohortstudy AT meixuanwan riskfactorsforandprognosisofpostoperativecardiaceventsinolderpatientswithhipfracturesaretrospectivecohortstudy AT shuaihaozhang riskfactorsforandprognosisofpostoperativecardiaceventsinolderpatientswithhipfracturesaretrospectivecohortstudy AT yuanminghe riskfactorsforandprognosisofpostoperativecardiaceventsinolderpatientswithhipfracturesaretrospectivecohortstudy AT daojingqiu riskfactorsforandprognosisofpostoperativecardiaceventsinolderpatientswithhipfracturesaretrospectivecohortstudy AT xiaoweiwang riskfactorsforandprognosisofpostoperativecardiaceventsinolderpatientswithhipfracturesaretrospectivecohortstudy AT zhiliu riskfactorsforandprognosisofpostoperativecardiaceventsinolderpatientswithhipfracturesaretrospectivecohortstudy AT xiaobinchen riskfactorsforandprognosisofpostoperativecardiaceventsinolderpatientswithhipfracturesaretrospectivecohortstudy AT chunhuaxi riskfactorsforandprognosisofpostoperativecardiaceventsinolderpatientswithhipfracturesaretrospectivecohortstudy |