Study: Hip arthroplasty for elderly hip fracture patients has higher risk of myocardial infarction, mortality compared to ORIF

PHOENIX — Researchers from the University of Maryland found an increased risk of myocardial infarction and related morality in patients who underwent hip arthroplasty to treat hip fractures compared with patients who underwent open reduction, internal fixation, according to a presenter at the Orthopaedic Trauma Association Annual Meeting, here.

“In patients, acute [myocardial infarction] MI is uncommon and differs by procedure,” Nathalie Urrunaga, MD, MS, said. “Post-MI mortality is high after hip surgery. We suggest that routine testing for acute MI could improve outcomes in this population.”

Urrunaga and colleagues collected data from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample and evaluated surgical results from 2,275,944 low-energy hip fracture patients who were 65 years or older, according to the abstract. The patients either underwent open reduction, internal fixation (ORIF), hemiarthroplasty (HA) or total hip arthroplasty (THA).

Patients were treated with ORIF in 63.4% of cases, with HA in 34% of cases and THA in 2.6% of cases. Overall, MI occurred in 2.2% of cases. Hemiarthroplasty patients had an MI complication rate of 2.5%, while ORIF patients had a 2% MI complication rate, according to the abstract. Regarding MI-related mortality, the risk was highest in patients who underwent THA, at 18.2%, while the overall risk was 8 times higher if the patient experienced MI complications.

Reference:

Urrunaga NH. Paper #39. Presented at: Orthopaedic Trauma Association Annual Meeting. Oct. 9-12, 2013; Phoenix.

Disclosure: The authors have no relevant financial disclosures.