The Researchers Analyzing the effects of preoperative echocardiography (ECG)  on patient survival, timing of surgery in length of hospital stay in Patients Who Will undergo hip nailing for an intertrochanteric fracture.

At the beginning of millennium 1.6 million patients worldwide had a fracture in a year and date show incidence is expected to increase. Hip fracture is a significant burden for health care and economics. 

Moreover, it is associated with a one-year mortality rate ranging from 14% to 36%. Many comorbidities that patients with hip fracture have increased the risk of mortality.  Heart disease is common in this elderly population and remains the most frequent cause of postoperative mortality

The clinical records of the patients who were admitted to the university hospital with an intertrochanteric femur fracture were retrospectively analyzed.

The age, gender, American Society of Anesthesiologists (ASA) score, days to surgery, total hospital stay, cardiac drug prescription / modification, cardiac intervention and ECG assessment including detailed findings were reviewed. Mortality data were accessed from the national civil registration system.

Of the 181 (110 women and 71 men; mean age 81 (44-98)) cases were studied whom 65 underwent pre-operative echocardiography .Time to surgery and total hospital stay was 2 days longer at transthoracic echocardiography ( TTE ) group (p <0.001).

At one month control group survival rate was 93.1% on contrary it was 75.4% at TTE group. One-year survival rates were 77.3% and 55.1% respectively. Likewise mean expected survival time was 21.6 ± 1.03 months for control group and 15.12 ± 1.64 months for TTE group (p <0.001).

Only increased left ventricular end diastolic diameter ( LVEDD ) is shown to be associated with increasing one-year mortality with a hazard ratio of 10.78 (2.572-45.19) at multivariate model.

The major limitation of this study is its retrospective nature . Making a deduction for mortality of patients with a retrospective cohort may have some complications .

Cardiac findings and requirement for preoperative TTE and increased LVEDD is a strong predictor for mortality. TTE significantly lengthens the time to surgery . Also LVEDD measurement can be easily performed in the bedside which we believe would save time and reduce mortality.