Decreased left ventricular (LV) function is associated with hip-fractures.

BACKGROUND: Several risk factors for falls and hip-fractures have been recognized, but controversy still exists toward the importance of structural cardiac abnormalities as a potentially modifiable risk factor for recurrent falls. Aim of this study was to determine the association between echocardiographic abnormalities and hip-fractures.

METHODS: Design case-control study within consecutive patients undergoing hip-surgery in an academic hospital.

CASES: patients with traumatic hip-fractures.

CONTROLS: patients undergoing planned hip surgery (non-traumatic).

INCLUSION CRITERIA: age≥50 years, presence of pre-operative echocardiogram.

EXCLUSION CRITERIA: high energy trauma, pathological and/or previous hip-fracture.

OUTCOME: echocardiographic abnormalities (ventricular function, atrial enlargement, valve stenosis and/or regurgitation, pulmonary hypertension (pulmonary artery pressure (PAP) ≥35mmHg)). Multivariate logistic regression was performed to calculate odds ratios (OR) and to correct for confounders.

RESULTS: We included 197 patients (141 cases). Mean age was 77 years (SD), 65% female. After adjustment for potential confounders, decreased LV systolic function was associated with hip-fractures (OR 3.2 [95%CI 1.1-9.1]). Increasing severity of LV dysfunction was also associated with hip-fractures (p for trend=0.012).

DISCUSSION: In conclusion, patients with traumatic hip-fracture had greater risk of decreased LV function than patients who underwent planned hip-surgery. Possibly, decreased LV function is an underestimated risk factor for injurious falls.