Outcome study of proximal femur fracture in patients having cardiac diseases

Abstract

To assess the outcome of fracture in patients with cardiac diseases, evaluate delay in surgery & study the quality of life post hospital discharge. A prospective review of the medical records of 32 cases who underwent surgery at Dayanand Medical college & Hospital, Ludhiana was performed. Patients were selected with proximal femur fracture having cardiac diseases after fulfilling the inclusion and exclusion criteria. After taking detailed history and examination, the patients were followed up after 4-6 weeks and 3-4 months. A detailed structured performa was filled and functional assessment was done using HHS. We had final follow up of all 32 patients which were included in the study managed by PFN. Modified HHS was accessed at 4-6 weeks and 3-4 months and found to be 41.19 (SD =12.89) & 64.66 (SD =13.35) respectively. No mortality was observed during the follow up. Presence of cardiac comorbidities increased the chances of hip fracture and poor HHS was observed among the patients in the study. Although no significant difference on HHS was observed among the subtypes of cardiac diseases. Most common cause of delay in surgery was the use of antiplatelet agents and delay in surgery affected the HHS significantly in a way that more the delay, poor was the HHS. Presence of comorbidities like hypertension, diabetes mellitus decreased the mean HHS. Occurrence of complications also affected the HHS. More the complications, poor was the HHS. Patients with hip fracture with a diagnosis of CVD, have greater risk of hip fracture with longer length of hospital stay and hence higher cost per hospital stay. Presence of more comorbidities along with CVD shows a significant association in the functional outcome.