Incidence of Myocardial Infarction Following Hip Fracture Repair: Higher than Predicted by National Guidelines

1Mayo Clinic, Rochester, MN
2Mayo Clinic, Rochester, MN
3Mayo Clinic, Rochester, MN
4Mayo Clinic, Rochester, MN
5Texas Tech University, Lubbock, TX
6Mayo Clinic, Rochester, MN
7Mayo Clinic, Rochester, MN
8Mayo Clinic, Rochester, MN

Meeting: Hospital Medicine 2008, April 3-5, San Diego, Calif.

Abstract number: 49

Background:

The preoperative combined risk of myocardial infarction (MI) and mortality following orthopedic surgeries is <5% (2007 ACC/AHA Perioperative Guideline). Very little is known about incidence of MI specifically following urgent hip fracture repair.

Methods:

The study was a population‐based retrospective cohort of 1195 patients who had hip fracture repair in Olmsted County, Minnesota, between January 1, 1988, and December 31, 2002. Data were obtained through complete medical record review of all inpatient, outpatient, and nursing home care for at least 1 year following the incident surgery.

Results:

Mean age of participants was 84.2 years, 80% were female, and 99% were white. The incidence of postoperative MI following hip fracture repair was 14.2% (95% CI 12.2, 16.1) at 7‐days and 14.4% (95% CI 12.4, 16.4), 15.3% (95% CI 13.2,17.3), and 16.4% (95% CI 14.2, 18.5) at 1 month, 6 months, and 1 year, respectively. Deaths were censored. Eighty‐eight percent of postoperative MIs occurred during the surgical hospitalization. The 1‐year survival of patients without MI during their index hospitalization was 80%, but only 64% for those with an inpatient MI.

Conclusions:

The 1‐year incidence of MI following hip fracture repair is 16.4%, with 88% of those occurring within the first 7 postoperative days. This is markedly higher than the published risk of postoperative myocardial infarction in the 2007 ACC/AHA Peri‐operative Guideline for intermediate‐risk orthopedic surgeries. Research is needed to determine if early perioperative medical interventions could decrease postoperative myocardial infarctions and improve survival.

Author Disclosure:

J. Huddleston, none; E. Casey, none; D. Larson, none; R. Gullerud, none; P. Huddleston, none; M. Phy, none; L. J. Melton, none; V. Roger, none.

To cite this abstract:

Huddleston J, Casey E, Gullerud R, Larson D, Phy M, Huddleston P, Melton L, Roger V. Incidence of Myocardial Infarction Following Hip Fracture Repair: Higher than Predicted by National Guidelines. Abstract published at Hospital Medicine 2008, April 3-5, San Diego, Calif. Abstract 49. Journal of Hospital Medicine. 2008; 3 (suppl 1). https://www.shmabstracts.com/abstract/incidence-of-myocardial-infarction-following-hip-fracture-repair-higher-than-predicted-by-national-guidelines/. Accessed November 13, 2019.

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