TY  - BOOK
AU  - Agrawal, RajeevbMHRI
AU  - Ammar, Hussam
AU  - Arar, Tareq 
AU  - Chai, Christina
AU  - Gadodia, Ritika 
AU  - Gautam, Monika 
AU  - Kallur, Akhil 
AU  - Meda, Namratha Seetharam 
AU  - Pristoop, Raphael
AU  - Rasheed, Ahmed Daniyaal 
AU  - Tuli, Aakash 
AU  - Zaghlol, Louay 
TI  - Impact of Preoperative Echocardiograms on In-Hospital Outcomes of Patients Undergoing Surgical Hip Fracture Repair and Their Clinical Appropriateness
SN  - 0038-4348
PY  - 2023///
KW  - *Hip Fractures
KW  - Adult
KW  - Echocardiography
KW  - Hip Fractures/dg [Diagnostic Imaging]
KW  - Hip Fractures/su [Surgery]
KW  - Hospitals
KW  - Humans
KW  - Length of Stay
KW  - Postoperative Complications/ep [Epidemiology]
KW  - Retrospective Studies
KW  - Automated
KW  - MedStar Health Research Institute
KW  - MedStar Washington Hospital Center
KW  - Hospitalist
KW  - Internal Medicine Residency
KW  - Journal Article
N1  - Available online through MWHC library: 2003 - present, Available in print through MWHC library: 1999 - 2006
N2  - CONCLUSIONS: Patients subjected to TTE before hip fracture surgery had a longer LOS and time to surgery, with higher mortality and intensive care unit up triage rates. TTE evaluations were typically conducted for inappropriate indications, which rarely made meaningful changes to patient management; METHODS: This retrospective chart review of adult patients admitted with hip fracture compared the length of stay (LOS), time to surgery, in-hospital mortality, and postoperative complications between TTE and non-TTE groups. TTE patients were risk stratified using the Revised Cardiac Risk Index (RCRI) to compare TTE indication according to current guidelines; OBJECTIVES: Preoperative transthoracic echocardiograms (TTE) before hip fracture repairs are controversial. This study aimed to quantify the frequency of ordering TTE, the appropriateness of testing based on current guidelines, and the impact of TTE on in-hospital morbidity and mortality outcomes; RESULTS: Of the 490 patients included in this study, 15% received preoperative TTE. The median LOS of the TTE and non-TTE groups was 7.0 and 5.0 d, respectively, whereas the median time to surgery was 34 and 14 h, respectively. The odds of in-hospital mortality remained significantly higher in the TTE group after adjusting for RCRI but not when adjusted for the Charlson Comorbidity Index. Significantly more patients in the TTE groups had postoperative heart failure and up triage in the intensive care unit. Furthermore, 48% of patients with an RCRI score of 0 received preoperative TTE, with cardiac history as the most typical indication. TTE changed perioperative management in 9% of patients
UR  - https://dx.doi.org/10.14423/SMJ.0000000000001558
ER  -