Atrial fibrillation as a preoperative risk factor predicts long-term mortality in elderly patients without heart failure and undergoing hip fracture surgery

Abstract

OBJECTIVE: Patients with atrial fibrillation (AF) constitute a significant portion of hip fracture patients, and both diseases tend to present more frequently in older age. Our goal was to evaluate the long-term mortality of patients with AF who were free from heart failure undergoing hip fracture surgery.METHODS: This observational, retrospective study was done in a single research and training hospital setting. Hospital electronic health record data, National Health Registry data, and National Death Registry System data for 233 consecutive patients who were above 65 years of age and were planned to undergo surgery for hip fracture were retrieved and analyzed. An experienced cardiologist evaluated the patients prior to surgery. Each member of the research cohort was categorized into one of the two groups based on their survival status (survivor and non-survivor groups). RESULTS:Of the 233 cases, 89 (38.2%) who were included in the investigation died during the follow-up period. The median long-term follow-up period was 34 (12-42) months. The frequency of AF was significantly higher in the non-survivor group. In multivariable Cox regression analysis, AF (HR: 2.195, 95%CI 1.365-3.415, p<0.001), advanced age, and blood urea level were determined as independent predictors for all-cause long-term mortality.CONCLUSIONS: AF is an independent predictor for long-term death in hip fracture cases above 65 years of age who were free from heart failure.

RETRACTED: The impact of chronic kidney disease and dialysis therapy on outcomes of elderly patients with hip fractures: A systematic review and meta-analysis

“…43,44 Hip fractures are one of the most commonly occurring co-morbidities of chronic kidney diseases, 16,45,46 and are associated with poor prognostic outcomes in terms of short-, long-term morbidity and mortality, especially for patients undergoing hemodialysis. [47][48][49][50] Current studies suggest that this predisposition toward fractures is a result of increased parathyroid hormone levels and the disruption in calcium-phosphorus metabolism in chronic kidney disease patients. 51,52 Studies have also suggested a direct relationship between the incidences of fracture and the severity of chronic kidney disease.…”

Association of Mitral Regurgitation with Postoperative Atrial Fibrillation in Critically Ill Noncardiac Surgery Patients: A Prospective Cohort Study

“… 7 AF is the risk factor for in-hospital mortality and long-term mortality in elderly patients undergoing hip fracture surgery. 41 , 42 In our study, although POAF did not show an influence on mortality, it was associated with perioperative myocardial infarction, acute kidney injury, and complications, such as infection, fistula, and bleeding. Patients with AF had prolonged mechanical ventilation time, ICU, and hospital length of stay.…”

The Nomogram Model and Factors for the Postoperative Mortality of Elderly Patients with Femoral Neck Fracture Undergoing Artificial Hip Arthroplasty: A Single‐Institution 6‐Year Experience

“…Elderly patients with decreased physiological reserve and poor tolerance to fracture‐caused traumatic stress and who have undergone surgery might have higher perioperative risk. Old age has also been reported as an independent predictive factor for death in elderly patients with hip fractures 28 . Age is the main risk factor for death in elderly patients with femoral neck fractures at 30 days 29 and 1 year 30,31 after surgery.…”

“…Old age has also been reported as an independent predictive factor for death in elderly patients with hip fractures. 28 Age is the main risk factor for death in elderly patients with femoral neck fractures at 30 days 29 and 1 year 30,31 after surgery.…”