Perioperative adverse cardiac events predict post-discharge mortality after fragility hip fracture in elderly patients without cardiovascular disease.

Background: Perioperative adverse cardiac events (PACEs) in elderly patients with hip fractures are associated with perioperative mortality. We investigated the relationship of PACE with post-discharge mortality and further explored whether it differs between patients with and without cardiovascular disease (CVD). Methods: We retrospectively analyzed data from patients aged ≥ 65 years who underwent fragility hip fracture surgery from September 2016 to December 2021. PACE was defined as a composite of congestive heart failure, cardiogenic shock, myocardial injury after non-cardiac surgery, arrhythmic event, ischemic stroke, or acute pulmonary thromboembolism during hospitalization or within the 30-day postoperative period. Patients with 30-day mortality were excluded. The primary endpoint was all-cause mortality after hospital discharge. Results: Of the 446 patients (133 patients in the CVD group and 313 patients in the non-CVD group), 14.8% experienced PACE, and overall mortality during a median of 15.9 months (interquartile range: 6.6-27.0 months) was 20.9% [CVD (26.3%) Conclusions: PACE was associated with increased post-discharge mortality after fragility hip fracture, especially in elderly patients without CVD.