Role of preoperative electrocardiography in predicting cardiovascular complications in proximal femur surgery

Objective: To evaluate whether a complete analysis of electrocardiograms (ECGs) taken before hip fracture surgery could provide prognostic data regarding in-hospital perioperative cardiovascular complications (PCVCs). Methods: Elderly patients who underwent surgery using a proximal femoral nail due to peritrochanteric fracture between 2009 and 2013 were retrospectively evaluated. Patients’ 12-lead preoperative ECGs were analyzed and corrected QT intervals (QTcs) were calculated. Following analysis, ECGs with atrial fibrillation, left or right bundle branch block, ventricular premature beats, Q-waves, ventricular strain, sinus bradycardia or tachycardia were designated as abnormal. The relationship between observed ECG abnormalities and calculated QTc interval, and the development of in-hospital PCVC was evaluated. Results: In total, 190 male and 232 female patients were included in the study. Two hundred nineteen (51.9%) patients had a fractured right hip and 203 (48.1%) had a fractured left hip. ECGs of 133 patients were abnormal. Seventeen patients (4.02%) died and 62 patients (14.6%) developed PCVCs. There was a statistically significant increase (P=0.0183) in PCVC as perioperative cardiac risk factors increased. Of the abnormal ECG changes, only atrial fibrillation, paced rhythm and ventricular strain were found to be related to PCVCs (P