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Several factors predict 1-year mortality after hip fracture surgery in elderly patients
Recently published data showed age older than 80 years, dementia and B-type natriuretic peptide led to a significant postoperative increase of 1-year mortality among patients undergoing hip fracture surgery.
Researchers evaluated comorbidities among 152 elderly patients undergoing hip fracture surgery. They measured B-type natriuretic peptide (BNP) and troponin I at baseline and at postoperative days 4 and 5, recorded any major cardiac events and assessed 1-year mortality. Researchers also analyzed comorbidity models with the important multivariate predictors of 1-year mortality.
Results showed during hospitalization 6% of patients experienced major cardiac events postoperatively. Researchers also found 2% of patients died postoperatively at days 5, 7 and 10 from autopsy-confirmed myocardial infarction, 2% of patients experienced a nonfatal myocardial infarction and 2% of patients experienced acute heart failure. Overall, 24% of patients had died at 1-year follow-up, according to results.
While univariate predictors of 1-year mortality included age older than 80 years, renal failure, cardiovascular disease, respiratory disease, Parkinson disease and dementia, a multivariate model showed age older than 80 years and dementia were important predictors of 1-year mortality. Researchers noted important predictors of 1-year mortality in all comorbidity models included age older than 80 years and dementia, and the most important predictor of 1-year mortality was postoperative increase in BNP.
A threshold of 90 ng/mL of preoperative BNP had an 82% sensitivity and 62% specificity to predict 1-year mortality, according to receiver operating characteristic curve analysis. Researchers found a 70% sensitivity and 77% specificity to predict the study endpoint with a threshold of 190 ng/mL of postoperative BNP. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.