Risk Factors for Cardiovascular Complications Following Hip Surgery

Kuen Tak Suh; Seung Joon Rhee; Jung Sub Lee; Jeung Il Kim

doi:10.5371/hp.2012.24.2.71

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Suh, Rhee, Lee, and Kim: Risk Factors for Cardiovascular Complications Following Hip Surgery

Original Article

Hip & Pelvis

Hip & Pelvis 2012; 24(2): 71-78.

Published online: 30 June 2012

DOI: https://doi.org/10.5371/hp.2012.24.2.71

Risk Factors for Cardiovascular Complications Following Hip Surgery

Kuen Tak Suh, MD, Seung Joon Rhee, MD, Jung Sub Lee, MD, Jeung Il Kim, MD

Department of Orthopedic Surgery, Pusan National University School of Medicine, Busan, Korea.

Address reprint request to Kuen Tak Suh, MD. Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan 626-770, Korea. TEL: +82-55-360-2125, FAX: +82-55-360-2155, kuentak@pusan.ac.kr

Received 11 April 2012 Revised 22 June 2012 Accepted 23 June 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was performed in order to analyze the incidence of postoperative cardiovascular complications in patients who had undergone hip surgery and to identify risk factors associated with these complications.

Materials and Methods

A total of 1,390 patients who had undergone hip surgery from 1998 to 2008 were divided into case or control groups according to occurrence of postoperative cardiovascular complications. Both groups were sorted and analyzed by age, gender, mode of operation, bilaterality and history of preoperative cardiovascular disease. Postoperative cardiovascular complication was defined as having any condition including myocardial infarction, congestive heart failure, unstable angina, arrhythmia, hypotension, or pulmonary thromboembolism during the surgical admission period.

Results

Forty three out of 1,390 patients(3.1%) experienced cardiovasucular complications and 1 patient (0.07%) died. Increasing patient age (P=0.001), history of bilateral hip surgery (P=0.000), hypertension (P=0.002), coronary artery disease (P=0.000) or valvular heart disease (P=0.010), and ASA category 3 (P=0.000) were all associated with significantly higher incidence of cardiovascular complications.

Conclusion

Intensive preoperative management though adequate hypertension control and prevention of coronary artery occlusive disease for patients who are elderly or receiving bilateral operation will help decrease the incidence of postoperative cardiovascular complications after hip surgery.

Keywords: Hip surgery, Cardiovascular complications

Figures and Tables

Table 1

Demographic Characteristics of the Patients

Demographic data of 1390 patients who underwent hip arthroplasty or hip fracture surgery from 1998 to 2008.

^*ASA: American Society of Anesthesiologists, ^†HTN: Hypertension, ^‡CAOD: Coronary Artery Occlusive Disease, ^§MI: Myocardial Infarction (MI), ^∥CHF: Congestive Heart Failure, ^¶VHD: Valvular Heart Disease

Table 2

Number of Postoperative Cardiovascular Complications in Case Group

5 patients developed more than 1 complication at the same time; arrhythmia+congestive heart failure (1), arrhythmia+hypotension (1), pulmonary thromboembolism+hypotension (1), congestive heart failure+hypotension (2)

Table 3

Comparison of the Patients with and without Cardiovascular Complications

43 out of 1390 patients (3.1%) had cardiovasucular complications. Patients were analyzed according to their age, gender, mode of operation, bilaterality; Case Group: patients who developed postoperative cardiovascular complication, Control Group: patients without complication.

^*THA: Total Hip Arthroplasty, ^†BH: Bipolar Hemiarthroplasty, ^‡Revision: Revision Hip Arthroplasty

Table 4

Preoperative Comorbidities and Postoperative Cardiovascular Complications

Case Group: patients who developed postoperative cardiovascular complication, Control Group: patients without complication ^*HTN: Hypertension, ^†CAOD: Coronary Artery Occlusive Disease, ^‡MI: Myocardial Infarction, ^§CHF: Congestive Heart Failure, ^∥VHD: Valvular Heart Disease

Table 5

Number of Preoperative Comorbidities and Postoperative Cardiovascular Complications

Preoperative comorbidities include hypertension, coronary artery occlusive disease, myocardial infarction, congestive heart failure, valvular heart disease.

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