With an increasing aging population, hip fractures represent a major and growing health care problem in Taiwan. Despite the use of prophylaxes, cardiovascular complications have been found to be a major predictor for mortality that contributes to between 26.8% and 63% of the deaths following surgery for hip fractured elderly patients in Western countries. In our previous clinical trials, we found that cardiovascular incidents contributed to between 50% and 54.5% of the deaths within one year after surgery, and from 25.4% to 29% of hospital re-admission within 6 months. However, there is a lack of studies on post-operative complications after hip fracture in Taiwan. Thus, the purpose of this study was to explore the post-operative cardio-vascular complications, their predictors and the influence they have on the post-operative recovery of hip fractured elderly persons.

 

Post-operative cardio-vascular complications including acute myocardial infarction, stroke, cardiac arrhythmia, pulmonary embolism (PE), and deep vein thrombosis (DVT) will be assessed by physical examination and D-dimer test, and confirmed by duplex ultrasonography or impedance plethysmography. Potential predictors for post-operative complications including age, gender, marital status, educational background, pre-fracture physical and cognitive functional abilities, type of hip fracture, medical complications, associated diseases and symptoms as well as operative risks will be explored. The influence of cardio-vascular complications on clinical outcomes including range of motion (ROM), pain, muscle strength and endurance, motor control, recovery of walking ability, aerobic and anaerobic capacity, flexibility, body position, complications, mortality, occurrence of re-fracture; self-care ability; service utilization, as well as quality of life measured by SF-36 will be investigated. A total of 208 elderly persons with a hip fracture and are scheduled to receive surgery will be recruited through the emergency room and will be followed prior to their surgery, prior to discharge, and at the 1st, 3rd, 6th and 12th month after discharge. Approval of the Institutional Review Board (IRB) of CGMH will be obtained prior to the start of the study. Generalized estimating equations analysis (GEE) will be used to analyze whether or not having post-operative complications influences the trajectories of the outcome variables. At the end, an intervention protocol will be developed based on the results of this study. The findings of this study can contribute to the current knowledge and practice for elderly patients with cardiovascular complications following hip fracture.