Background
Hip fracture has become one of main problem in the elderly patients by progress of the aging society. Transthoracic echocardiography (TTE) is still widely performed for purpose of assessing the risk associated cardiovascular disease in individuals who undergo hip fracture surgery while routine echocardiography was not recommended for the preoperative assessment in individuals undergoing noncardiac surgery by recently published international guidelines. Thus, we evaluated the relevance of the variables of TTE and the outcomes in elderly patients with hip fracture.
Material and methods
We conducted single-center, retrospective medical record review including a total of 356 patients. The study population included patients 65 years of age and older underwent TTE within a month before the scheduled hip fracture surgery for the pre-operative assessment between January 2013 and October 2016. Bilateral hip fracture surgery and re-operation due to complication of the previous hip surgery were excluded.​
Primary outcome was 30-day mortality after surgery, secondary outcomes were postoperative neurologic and cardiovascular complications. Univariable and multivariable logistic regression were performed to identify whether echocardiographic variables are related to postoperative mortality and complications.
Results
The mean age was 79.7 years (SD=6.7) and 78 (21.9%) were male. Six patients died within 30 days. There was a significant difference in mean age between the survival group and 30-day mortality group(table1). Delirium was the most common postoperative complication (46, 12.9%), and cardiovascular disease was the second most common complication (17, 4.8%). ​
Among TTE variables only LA volume index was found to be associated with postoperative cardiovascular complication in both the univariable and multivariable logistic regression analysis (Table 2).
Conclusions
This study shows that patient’s age was associated postoperative mortality. More careful screening of the elderly patients for pre-operative echocardiography will be necessary.

Association between preoperative transthoracic echocardiography and clinical outcomes after scheduled hip fracture surgery in geriatric patients