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Pre-operative echocardiogram in hip fracture patients with cardiac murmur- an audit
BACKGROUND: All hip fracture patients with a cardiac murmur have an echocardiogram as a part of their preoperative work-up in our unit. We performed a retrospective audit to assess the impact of obtaining a pre-operative echocardiogram on the management of hip fracture patients. METHODS: All hip fra...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3189143/ https://www.ncbi.nlm.nih.gov/pubmed/21943077 http://dx.doi.org/10.1186/1749-799X-6-49 |
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author | Jettoo, Prithee Kakwani, Rajesh Junejo, Shahid Talkhani, Imtiyaz Dixon, Paul |
author_facet | Jettoo, Prithee Kakwani, Rajesh Junejo, Shahid Talkhani, Imtiyaz Dixon, Paul |
author_sort | Jettoo, Prithee |
collection | PubMed |
description | BACKGROUND: All hip fracture patients with a cardiac murmur have an echocardiogram as a part of their preoperative work-up in our unit. We performed a retrospective audit to assess the impact of obtaining a pre-operative echocardiogram on the management of hip fracture patients. METHODS: All hip fracture patients (N = 349) between 01/06/08 and 01/06/09 were included in the study. 29 patients had pre-operative echocardiogram (echo group). A computer generated randomised sample of 40 patients was generated from N, 'non-echo' group. Data was obtained from medical records and the Hospital Information Support System (HISS). The groups were compared using Student's t test. Approval was obtained locally from the clinical governance department for this project. RESULTS: Age and gender distribution were similar in both groups. Indication for echo was an acute cardiac abnormality in 4 cases. 25 patients had echo for no new cardiac problem (indication being cardiac murmur in 23 patients and extensive cardiac history in 2 cases). Cardiology opinion was sought in 5 cases. No patient required cardiac surgery or balloon angioplasty preoperatively. Patients having pre-operative echo had significant delay to surgery (average 2.7 days, range 0-6 days) compared to 'non-echo' group (average 1.1 days, range 0-3 days), (p < 0.001). There was no significant difference in length of stay (p = 0.14) and mortality at 30 days (p = 0.41) between the groups. CONCLUSION: We have developed departmental guidelines for expediting echo requests in hip fracture patients with cardiac murmur. A liaison has been established with our cardiology department to prioritise such patients on the Echocardiography waiting list, to prevent unnecessary avoidable delay. Careful patient selection for pre-operative echocardiography is important to avoid unnecessary delay to surgery. |
format | Online Article Text |
id | pubmed-3189143 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-31891432011-10-08 Pre-operative echocardiogram in hip fracture patients with cardiac murmur- an audit Jettoo, Prithee Kakwani, Rajesh Junejo, Shahid Talkhani, Imtiyaz Dixon, Paul J Orthop Surg Res Research Article BACKGROUND: All hip fracture patients with a cardiac murmur have an echocardiogram as a part of their preoperative work-up in our unit. We performed a retrospective audit to assess the impact of obtaining a pre-operative echocardiogram on the management of hip fracture patients. METHODS: All hip fracture patients (N = 349) between 01/06/08 and 01/06/09 were included in the study. 29 patients had pre-operative echocardiogram (echo group). A computer generated randomised sample of 40 patients was generated from N, 'non-echo' group. Data was obtained from medical records and the Hospital Information Support System (HISS). The groups were compared using Student's t test. Approval was obtained locally from the clinical governance department for this project. RESULTS: Age and gender distribution were similar in both groups. Indication for echo was an acute cardiac abnormality in 4 cases. 25 patients had echo for no new cardiac problem (indication being cardiac murmur in 23 patients and extensive cardiac history in 2 cases). Cardiology opinion was sought in 5 cases. No patient required cardiac surgery or balloon angioplasty preoperatively. Patients having pre-operative echo had significant delay to surgery (average 2.7 days, range 0-6 days) compared to 'non-echo' group (average 1.1 days, range 0-3 days), (p < 0.001). There was no significant difference in length of stay (p = 0.14) and mortality at 30 days (p = 0.41) between the groups. CONCLUSION: We have developed departmental guidelines for expediting echo requests in hip fracture patients with cardiac murmur. A liaison has been established with our cardiology department to prioritise such patients on the Echocardiography waiting list, to prevent unnecessary avoidable delay. Careful patient selection for pre-operative echocardiography is important to avoid unnecessary delay to surgery. BioMed Central 2011-09-23 /pmc/articles/PMC3189143/ /pubmed/21943077 http://dx.doi.org/10.1186/1749-799X-6-49 Text en Copyright ©2011 Jettoo et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Jettoo, Prithee Kakwani, Rajesh Junejo, Shahid Talkhani, Imtiyaz Dixon, Paul Pre-operative echocardiogram in hip fracture patients with cardiac murmur- an audit |
title | Pre-operative echocardiogram in hip fracture patients with cardiac murmur- an audit |
title_full | Pre-operative echocardiogram in hip fracture patients with cardiac murmur- an audit |
title_fullStr | Pre-operative echocardiogram in hip fracture patients with cardiac murmur- an audit |
title_full_unstemmed | Pre-operative echocardiogram in hip fracture patients with cardiac murmur- an audit |
title_short | Pre-operative echocardiogram in hip fracture patients with cardiac murmur- an audit |
title_sort | pre-operative echocardiogram in hip fracture patients with cardiac murmur- an audit |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3189143/ https://www.ncbi.nlm.nih.gov/pubmed/21943077 http://dx.doi.org/10.1186/1749-799X-6-49 |
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