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.