Analysis on risk factors of postoperative cardiovascular complications in the elderly patients with hip fracture / 临床麻醉学杂志

ABSTRACT

Objective To investigate the risk factors of postoperative cardiovascular complica-tions in elderly patients with hip fracture during hospitalization.Methods A retrospective analysis was conducted according to the medical records of 693 elderly patients with hip fracture admitted to our hospital from January,2005 to December,2015.There were 257 males and 436 females,aged 65-103 years and body mass index (BMI)16.5-33.1 kg/m2,ASA physical status Ⅱ-Ⅳ.The demo-graphic data,preoperative comorbidities,time before surgery,surgical types,anesthetic methods, operation time and blood loss were recorded.Multivariate logistic regression analysis was applied to analyze the risk factors of postoperative cardiovascular complications in elderly patients with hip frac-ture during hospitalization.Results Postoperative cardiovascular complications occurred in 46 (46/693,morbidity:6.64%),including angina pectoris,arrhythmia,heart failure,myocardial infarction and sudden cardiac death.Univariate analysis showed that the independent variables of postoperative cardiovascular complications were age,cardiac comorbidities,hypertention,diabetes mellitus,cere-brovascular disease,renal insufficiency and anesthetic methods (P < 0.05).Multiple logistic regression analysis showed that age(OR=1.11,95% CI 1.06-1.17,P<0.001),cardiac comorbidi-ties (OR=1.98,95% CI 1.02-3.85,P=0.045),hypertention(OR=2.61,95% CI 1.23-5.51,P=0.012),diabetes mellitus (OR=2.06,95% CI 1.04-4.09,P=0.039),cerebrovascular disease (OR=2.14,95% CI 1.06-4.32,P=0.033)and renal insufficiency (OR=17.42,95% CI 3.69-82.80,P<0.001)were independent risk factors for postoperative cardiovascular complications in elderly patients with hip fracture during hospitalization.Conclusion Age,cardiac comorbidities,hy-pertention,diabetes mellitus,cerebrovascular disease and renal insufficiency are independent predictors for postoperative cardiovascular complications in elderly patients with hip fracture during hospitalization.