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Current Research: Cardiology

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Role of preoperative electrocardiography in predicting cardiovascular complications in proximal femur surgery

Author(s): Regayip Zehir, Sinan Zehir and Gonenc Kocabay*

Objective: To evaluate whether a complete analysis of electrocardiograms (ECGs) taken before hip fracture surgery could provide prognostic data regarding in-hospital perioperative cardiovascular complications (PCVCs).

Methods: Elderly patients who underwent surgery using a proximal femoral nail due to peritrochanteric fracture between 2009 and 2013 were retrospectively evaluated. Patients’ 12-lead preoperative ECGs were analyzed and corrected QT intervals (QTcs) were calculated. Following analysis, ECGs with atrial fibrillation, left or right bundle branch block, ventricular premature beats, Q-waves, ventricular strain, sinus bradycardia or tachycardia were designated as abnormal. The relationship between observed ECG abnormalities and calculated QTc interval, and the development of in-hospital PCVC was evaluated.

Results: In total, 190 male and 232 female patients were included in the study. Two hundred nineteen (51.9%) patients had a fractured right hip and 203 (48.1%) had a fractured left hip. ECGs of 133 patients were abnormal. Seventeen patients (4.02%) died and 62 patients (14.6%) developed PCVCs. There was a statistically significant increase (P=0.0183) in PCVC as perioperative cardiac risk factors increased. Of the abnormal ECG changes, only atrial fibrillation, paced rhythm and ventricular strain were found to be related to PCVCs (P<0.001, P<0.03 and P<0.001, respectively). It was found that PCVCs increased significantly as the QT interval increased (P<0.0001). QTc prolongation was correlated with PCVC.

Conclusion: ECG changes before hip fracture surgery, especially QTc prolongation, was found to be closely linked to PCVCs.