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John L. Dart Library
9 a.m. – 7 p.m.
Phone: (843) 722-7550
West Ashley Library
9 a.m. – 7 p.m.
Phone: (843) 766-6635
Folly Beach Library
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Phone: (843) 588-2001
Edgar Allan Poe/Sullivan's Island Library
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Phone: (843) 883-3914
Wando Mount Pleasant Library
9 a.m. – 8 p.m.
Phone: (843) 805-6888
Village Library
9 a.m. – 6 p.m.
Phone: (843) 884-9741
St. Paul's/Hollywood Library
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Otranto Road Library
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Mt. Pleasant Library
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McClellanville Library
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Keith Summey North Charleston Library
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John's Island Library
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Hurd/St. Andrews Library
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Miss Jane's Building (Edisto Library Temporary Location)
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Dorchester Road Library
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Preoperative Noninvasive Cardiac Testing in Older Adults with Hip Fracture: A Multi‐Site Study.
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- Author(s): Sinvani, Liron (AUTHOR); Mendelson, Daniel A. (AUTHOR); Sharma, Ankita (AUTHOR); Nouryan, Christian N. (AUTHOR); Fishbein, Joanna S. (AUTHOR); Qiu, Michael G. (AUTHOR); Zeltser, Roman (AUTHOR); Makaryus, Amgad N. (AUTHOR); Wolf‐Klein, Gisele P. (AUTHOR)
- Source:
Journal of the American Geriatrics Society. Aug2020, Vol. 68 Issue 8, p1690-1697. 8p. 1 Chart, 4 Graphs. - Source:
- Additional Information
- Subject Terms:
- Abstract: BACKGROUND/OBJECTIVES For older adults with acute hip fracture, use of preoperative noninvasive cardiac testing may lead to delays in surgery, thereby contributing to worse outcomes. Our study objective was to evaluate the preoperative use of pharmacologic stress testing and transthoracic echocardiogram (TTE) in older adults hospitalized with hip fracture. DESIGN Retrospective chart review. SETTING Seven hospitals (three tertiary, four community) within a large health system. PARTICIPANTS Patients, aged 65 years and older, hospitalized with hip fracture (n = 1,079; mean age = 84.2 years; 75% female; 82% white; 36% married). MEASUREMENTS Data were extracted from electronic medical records. The study evaluated associations between patient factors as well as clinical outcomes (time to surgery [TTS], length of stay [LOS], and in‐hospital mortality) and the use of preoperative noninvasive cardiac testing (pharmacologic stress tests or TTE). Descriptive statistics were calculated. Cox regression was performed for both TTS and LOS (evaluated as time‐dependent variable); logistic regression was used for in‐hospital mortality. RESULTS: Although 34.3% (n = 370) had a preoperative TTE,.7% (n = 8) underwent a nuclear stress test and none had a dobutamine stress echocardiogram. Median TTS was 1.1 days (IQR [interquartile range] =.8‐1.8 days), median LOS was 5.3 days (IQR = 4.2‐7.2 days), and in‐hospital mortality was 3% (n = 32). Patients admitted to the medical service had 3.5 times greater odds of undergoing a TTE compared with those on the orthopedic service (P <.001). Community hospitals had almost three times greater odds of preoperative TTE than tertiary centers (P <.001). In multivariable analysis, preoperative TTE was significantly associated with increased TTS (P <.001). No difference in mortality was found between patients with and without a preoperative TTE. CONCLUSION: This study highlights the high rate of TTE in preoperative assessment of older adults with acute hip fracture. Given the association between TTE and longer TTS, further studies must clarify the role of preoperative TTE in this population. J Am Geriatr Soc 68:1690‐1697, 2020. See related Special Series On Orthogeriatrics by Wolfe et al. in this issue. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Journal of the American Geriatrics Society is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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