• Andrew Marcantonio, Brandon Steen, Michael Kain, Kasey-Jean Bramlett, John F Tilzey, and Richard Iorio.
• Bull Hosp Jt Dis (2013). 2015 Dec 1; 73 (4): 239-42.

PurposeThe purpose of this study was to evaluate preoperative transthoracic echocardiography (TTE) on cardiac intervention, length of stay (LOS), inpatient mortality, and costs.MethodsA retrospective series of 43 preoperative TTE and 161 non-TTE (control) hip fracture patients (> 65 years) was reviewed. The data collected included ASA score, comorbidities, indication for TTE, perioperative cardiac intervention, LOS, inpatient mortality, and cost.ResultsOne of 43 (2.4%) (TTE) had a cardiac intervention (PTCA/CABG). Zero interventions occurred in the control group. The average time to operation was 1.5 days (TTE) and 0.93 days (control) (p < 0.001). The average LOS was 7.2 days (TTE) and 6.0 days (control), (p = 0.04). Patients (American Society of Anesthesiologists Physical Status Classification 3 and 4 patients), LOS was 7.3 days (TTE) and 6.3 days (control) (p = 0.18). Inpatient mortality was 2.3% (TTE) and 3% (control) (p = 0.493). There was no correlation between TTE and anesthesia. Hospital costs were different between groups (TTE $24,445 and control $18,429, p = 0.02).ConclusionsPreoperative TTE in elderly patients with hip fractures resulted in a low cardiac intervention rate. Patients undergoing preoperative TTE prior to surgery had longer times to operation, LOS, and higher hospital costs. The utility of TTE as a preoperative screening tool is limited in the geriatric hip fracture population and does not appear to effect perioperative mortality rates.

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