In a retrospective review of hip fracture patients, researchers confirmed the overuse of preoperative cardiac consults without measureable changes in cardiac intervention, which could lead to delays in surgical intervention and longer hospital stays.
Researchers retrospectively identified 266 patients with hip fractures who were admitted to a level 1 trauma center from 2010 to 2012. Researchers recorded patients’ prehospitalization status, including ambulatory status, living situation and comorbidities, and reviewed charts for criteria that would meet the American College of Cardiology (ACC) and the American Heart Association (AHA) guidelines, as well as patients who received cardiac consult.
Results showed 21% of patients received preoperative cardiac consultations. Of the patients who received preoperative cardiac consultations, 29% met the ACC/AHA guidelines for preoperative cardiac evaluations and 71% received unnecessary cardiac consults, according to researchers. Researchers also noted 1.4% of patients who did not receive a cardiac consult met ACC/AHA guidelines.
Although there was no significant difference in the type of anesthesia received by patients who met ACC/AHA guidelines and patients who did not meet these guidelines, results showed increased monitoring by the anesthesiologist among patients who met these guidelines. According to study results, there was a significantly longer average time to surgery and a significantly longer hospital length of stay among patients who received a preoperative cardiac consult, but did not meet guidelines for cardiac consults. A comparison of patients who received a cardiac consult and patients who did not showed no significant differences in postoperative complications or disposition. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.