The management and mortality of patients undergoing hip fracture surgery following recent acute myocardial infarction.

Having major elective surgery within 6 months of an Acute Myocardial Infarction carries an increased risk of re-infarction and death. However delaying surgery in patients with proximal femoral neck fractures would most likely lead to complications secondary to prolonged immobilisation and also provide difficulties with regards to nursing care. The aim of this retrospective study was to assess the mortality of hip fracture patients with a recent myocardial infarction that have undergone surgery at our institution. During the period January 2005 to September 2007, twenty-five patients were identified with an Acute Myocardial Infarction around the time of admission but prior to surgical treatment. There were 20 female and 5 male patients with an average age of 88 years (range: 78 to 98). All patients underwent surgery between 1 and 12 days post Acute Myocardial Infarction. We report mortality rates of 28% and 40% at 1 and 6 months respectively, which is much higher than that of the overall proximal femoral neck fracture population. This group of patients can provide a major dilemma to surgeons and anaesthetists alike with respect to the type and timing of surgery. We hope that this data, the largest published series to date, can provide accurate and timely prognostic information to not only clinicians, but also patients and relatives at such a difficult time.