Myocardial Injury in Patients with Hip Fracture-Reference-Cited by-同舟云学术

Myocardial Injury in Patients with Hip Fracture

Published:2024-07-25 Issue: Volume: Page:
ISSN:0021-9355
Container-title:Journal of Bone and Joint Surgery
language:en
Short-container-title:

Author:

Borges Flavia K.¹²³^ORCID,Guerra-Farfan Ernesto⁴^ORCID,Bhandari Mohit⁵^ORCID,Patel Ameen²^ORCID,Slobogean Gerard⁶^ORCID,Feibel Robert J.⁷^ORCID,Sancheti Parag K.⁸^ORCID,Tiboni Maria E.²^ORCID,Balaguer-Castro Mariano⁹¹⁰^ORCID,Tandon Vikas²^ORCID,Tomas-Hernandez Jordi¹¹^ORCID,Sigamani Alben¹²^ORCID,Sigamani Alen¹³^ORCID,Szczeklik Wojciech¹⁴^ORCID,McMahon Stephen J.¹⁵^ORCID,Ślęczka Pawel¹⁶,Ramokgopa Mmampapatla T.¹⁷^ORCID,Adinaryanan S.¹⁸,Umer Masood¹⁹^ORCID,Jenkinson Richard J.²⁰²¹^ORCID,Lawendy Abdel²²²³^ORCID,Popova Ekaterine²⁴²⁵^ORCID,Nur Aamer Nabi²⁶,Wang Chew Yin²⁷^ORCID,Vizcaychipi Marcela²⁸,Biccard Bruce M.²⁹^ORCID,Ofori Sandra²^ORCID,Spence Jessica³⁰^ORCID,Duceppe Emmanuelle¹³¹^ORCID,Marcucci Maura¹²³^ORCID,Harvey Valerie¹^ORCID,Balasubramanian Kumar³²^ORCID,Vincent Jessica³³^ORCID,Tonelli Ana Claudia¹³⁴³⁵^ORCID,Devereaux P.J.¹²³^ORCID,

Affiliation:

1. Population Health Research Institute, Hamilton, Ontario, Canada

2. Department of Medicine, McMaster University, Hamilton, Ontario, Canada

3. Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada

4. Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Vall d’Hebron, Barcelona, Spain

5. Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada

6. Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland

7. Division of Orthopaedic Surgery, Department of Surgery, The Ottawa Hospital - General Campus, University of Ottawa, Ottawa, Ontario, Canada

8. Sancheti Institute for Orthopaedics & Rehabilitation & PG College, Pune, India

9. Department of Orthopaedic Surgery and Traumatology, Parc Taulí Hospital Universitario, Sabadell, Spain

10. Department of Orthopaedic Surgery and Traumatology, Hospital Clinic Barcelona, Barcelona, Spain

11. Orthopaedic and Traumatology Department, Vall d’Hebron Hospital, Barcelona, Spain

12. Numen Health Bangalore, Bangalore, India

13. Department of Orthopedics, Government TD Medical College, Vandanam, India

14. Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Krakow, Poland

15. Department of Surgery, Oak Valley Health, Markham, Ontario, Canada

16. Independent Public Health Care Center, SPZOZ Myślenice, Myślenice, Poland

17. Division of Orthopaedic Surgery, University of the Witwatersrand, Johannesburg, South Africa

18. Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India

19. Department of Surgery, Aga Khan University, Karachi City, Pakistan

20. Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada

21. Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario Canada

22. Department of Surgery, University of Western Ontario, London, Ontario, Canada

23. Lawson Health Research Institute, London, Ontario, Canada

24. The Sant Pau Biomedical Research Institute, Barcelona, Spain

25. Iberoamerican Cochrane Center, Barcelona, Spain

26. Department of Orthopaedic Surgery, Shifa International Hospital, Islamabad, Pakistan

27. Department of Anaesthesiology, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia

28. Section of Anaesthetics, Pain Medicine & Intensive Care, Department of Surgery and Cancer, Imperial College London, Chelsea and Westminster Hospital, London, United Kingdom

29. Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, University of Cape Town, Western Cape, South Africa

30. Department of Anesthesia and Critical Care, McMaster University, Hamilton, Ontario, Canada

31. Department of Medicine, University of Montreal, Montreal, Quebec, Canada

32. Department of Statistics, Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton, Ontario, Canada

33. Perioperative Medicine and Surgical Research Unit, Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton, Ontario, Canada

34. Department of Medicine, Unisinos University, São Leopoldo, Brazil

35. Internal Medicine Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil

Abstract

Background: Myocardial injury after a hip fracture is common and has a poor prognosis. Patients with a hip fracture and myocardial injury may benefit from accelerated surgery to remove the physiological stress associated with the hip fracture. This study aimed to determine if accelerated surgery is superior to standard care in terms of the 90-day risk of death in patients with a hip fracture who presented with an elevated cardiac biomarker/enzyme measurement at hospital arrival. Methods: The HIP fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) trial was a randomized controlled trial designed to determine whether accelerated surgery for hip fracture was superior to standard care in reducing death or major complications. This substudy is a post-hoc analysis of 1392 patients (from the original study of 2970 patients) who had a cardiac biomarker/enzyme measurement (>99.9% had a troponin measurement and thus “troponin” is the term used throughout the paper) at hospital arrival. The primary outcome was all-cause mortality. The secondary composite outcome included all-cause mortality and non-fatal myocardial infarction, stroke, and congestive heart failure 90 days after randomization. Results: Three hundred and twenty-two (23%) of the 1392 patients had troponin elevation at hospital arrival. Among the patients with troponin elevation, the median time from hip fracture diagnosis to surgery was 6 hours (interquartile range [IQR] = 5 to 13) in the accelerated surgery group and 29 hours (IQR = 19 to 52) in the standard care group. Patients with troponin elevation had a lower risk of mortality with accelerated surgery compared with standard care (17 [10%] of 163 versus 36 [23%] of 159; hazard ratio [HR] = 0.43 [95% confidence interval (CI) = 0.24 to 0.77]) and a lower risk of the secondary composite outcome (23 [14%] of 163 versus 47 [30%] of 159; HR = 0.43 [95% CI = 0.26 to 0.72]). Conclusions: One in 5 patients with a hip fracture presented with myocardial injury. Accelerated surgery resulted in a lower mortality risk than standard care for these patients; however, these findings need to be confirmed. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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