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Article

Impact of Heart Failure on In-Hospital Outcomes after Surgical Femoral Neck Fracture Treatment

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Internal Medicine Department, Hospital Clínico San Carlos, Universidad Complutense, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos IdISSC, 28040 Madrid, Spain
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Servicio de Control de Gestión, Hospital 12 de Octubre, 28041 Madrid, Spain
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Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Universidad Complutense, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos IdISSC, 28040 Madrid, Spain
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Fundación Para la Mejora de la Asistencia Sanitaria, Elola Consultores, 28008 Madrid, Spain
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Service de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
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Internal Medicine Department, Hospital Universitario de Fuenlabrada, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, 28942 Madrid, Spain
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Internal Medicine Department, Hospital Universitario Rey Juan Carlos, Facultad de Ciencias de la Salud, Alcorcón, Universidad Rey Juan Carlos, 28933 Madrid, Spain
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Traumatology Department, Hospital Clínico San Carlos, Universidad Complutense, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos IdISSC, 28040 Madrid, Spain
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Author to whom correspondence should be addressed.
Academic Editor: Napoleon Perez-Farinos
J. Clin. Med. 2021, 10(5), 969; https://doi.org/10.3390/jcm10050969
Received: 19 December 2020 / Revised: 20 February 2021 / Accepted: 22 February 2021 / Published: 2 March 2021
(This article belongs to the Section Epidemiology & Public Health)
Background: Femoral neck fracture (FNF) is a common condition with a rising incidence, partly due to aging of the population. It is recommended that FNF should be treated at the earliest opportunity, during daytime hours, including weekends. However, early surgery shortens the available time for preoperative medical examination. Cardiac evaluation is critical for good surgical outcomes as most of these patients are older and frail with other comorbid conditions, such as heart failure. The aim of this study was to determine the impact of heart failure on in-hospital outcomes after surgical femoral neck fracture treatment. Methods: We performed a retrospective study using the Spanish National Hospital Discharge Database, 2007–2015. We included patients older than 64 years treated for reduction and internal fixation of FNF. Demographic characteristics of patients, as well as administrative variables, related to patient’s diseases and procedures performed during the episode were evaluated. Results: A total of 234,159 episodes with FNF reduction and internal fixation were identified from Spanish National Health System hospitals during the study period; 986 (0.42%) episodes were excluded, resulting in a final study population of 233,173 episodes. Mean age was 83.7 (±7) years and 179,949 (77.2%) were women (p < 0.001). In the sample, 13,417 (5.8%) episodes had a main or secondary diagnosis of heart failure (HF) (p < 0.001). HF patients had a mean age of 86.1 (±6.3) years, significantly older than the rest (p < 0.001). All the major complications studied showed a higher incidence in patients with HF (p < 0.001). Unadjusted in-hospital mortality was 4.1%, which was significantly higher in patients with HF (18.2%) compared to those without HF (3.3%) (p < 0.001). The average length of stay (LOS) was 11.9 (±9.1) and was also significantly higher in the group with HF (16.5 ± 13.1 vs. 11.6 ± 8.7; p < 0.001). Conclusions: Patients with HF undergoing FNF surgery have longer length of stay and higher rates of both major complications and mortality than those without HF. Although their average length of stay has decreased in the last few years, their mortality rate has remained unchanged. View Full-Text
Keywords: heart failure; femoral neck fracture; in-hospital outcomes heart failure; femoral neck fracture; in-hospital outcomes
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MDPI and ACS Style

Marco-Martínez, J.; Bernal-Sobrino, J.L.; Fernández-Pérez, C.; Elola-Somoza, F.J.; Azaña-Gómez, J.; García-Klepizg, J.L.; Andrès, E.; Zapatero-Gaviria, A.; Barba-Martin, R.; Marco-Martinez, F.; Canora-Lebrato, J.; Lorenzo-Villalba, N.; Méndez-Bailón, M. Impact of Heart Failure on In-Hospital Outcomes after Surgical Femoral Neck Fracture Treatment. J. Clin. Med. 2021, 10, 969. https://doi.org/10.3390/jcm10050969

AMA Style

Marco-Martínez J, Bernal-Sobrino JL, Fernández-Pérez C, Elola-Somoza FJ, Azaña-Gómez J, García-Klepizg JL, Andrès E, Zapatero-Gaviria A, Barba-Martin R, Marco-Martinez F, Canora-Lebrato J, Lorenzo-Villalba N, Méndez-Bailón M. Impact of Heart Failure on In-Hospital Outcomes after Surgical Femoral Neck Fracture Treatment. Journal of Clinical Medicine. 2021; 10(5):969. https://doi.org/10.3390/jcm10050969

Chicago/Turabian Style

Marco-Martínez, Javier, José L. Bernal-Sobrino, Cristina Fernández-Pérez, Francisco J. Elola-Somoza, Javier Azaña-Gómez, José L. García-Klepizg, Emmanuel Andrès, Antonio Zapatero-Gaviria, Raquel Barba-Martin, Fernando Marco-Martinez, Jesus Canora-Lebrato, Noel Lorenzo-Villalba, and Manuel Méndez-Bailón. 2021. "Impact of Heart Failure on In-Hospital Outcomes after Surgical Femoral Neck Fracture Treatment" Journal of Clinical Medicine 10, no. 5: 969. https://doi.org/10.3390/jcm10050969

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