SHM Converge Scientific Abstract ePoster Gallery-Impact of Perioperative Myocardial Ischemia on Long-Term Outcomes After Hip Fracture Surgery

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This retrospective study examined the impact of perioperative myocardial ischemia on long-term outcomes after hip fracture surgery. Researchers reviewed 248 patients who underwent hip fracture repair between April 2016 and July 2021. They evaluated three related ischemic syndromes: myocardial injury after noncardiac surgery (MINS), perioperative myocardial injury (PMI), and postoperative myocardial infarction (postop-MI), using perioperative troponin T measurements and standard clinical criteria.<br /><br />MINS was defined as a peak postoperative troponin T of at least 0.03 ng/mL from an ischemic cause within 30 days. PMI was defined as a rise of at least 0.03 ng/mL between pre- and postoperative troponin values or between two consecutive postoperative values. Postop-MI required troponin elevation plus clinical or diagnostic evidence of infarction, such as ischemic symptoms, ECG changes, pathologic Q waves, imaging evidence, or coronary thrombosis.<br /><br />The study found substantial mortality after hip fracture surgery overall: 21% at 1 year and 32% at 2 years. MINS occurred in 16.9% of patients, PMI in 8.9%, and postop-MI in 8.9%. All three conditions were strongly associated with worse 1-year survival. One-year mortality was 52.3% in patients with MINS versus 18.2% without, 59.1% with PMI versus 26.7% without, and 59.1% with postop-MI versus 31% without, all highly significant.<br /><br />The authors conclude that perioperative ischemic events are common and are major predictors of mortality after hip fracture surgery. Because these events are often silent due to perioperative analgesia, routine troponin surveillance may help detect myocardial injury earlier and allow timely intervention. They also emphasize the need for further research on troponin monitoring and postoperative follow-up to improve outcomes in this high-risk population.

Asset Subtitle

Rahul Mehta

Meta Tag

Author List Aditya Singh, Ashley Chipoletti, David B. Weiss, Joseph J. Caruso, Lukas Lauer, Rahul Mehta, Sula Mazimba, Wendy Novicoff

Category Research

Concept Perioperative Myocardial Ischemic Syndrome

Concept Postoperative Myocardial Injury

Concept Hip Fracture Repair

Concept Perioperative Myocardial Infarction

Concept Postoperative Myocardial Infarction

Distinguished Non-Finalist

Presenter Organization University of Virginia

Presenting Author Rahul Mehta

Track Perioperative

Keywords

hip fracture surgery

perioperative myocardial ischemia

myocardial injury after noncardiac surgery

MINS

perioperative myocardial injury

PMI

postoperative myocardial infarction

troponin T

mortality

troponin surveillance

Perioperative Myocardial Ischemic Syndrome

Postoperative Myocardial Injury

Hip Fracture Repair

Perioperative Myocardial Infarction

Postoperative Myocardial Infarction