Abstract
Background:
Atrial fibrillation (AF) is a common cardiac arrhythmia, particularly among older patients. Its presence in patients undergoing hip fracture surgery can complicate perioperative management and is associated with increased morbidity. Evaluating both pre-existing and new-onset AF in this population can guide more targeted interventions, vigilance and improve patient outcomes.
Objective:
To analyze the prevalence of pre-existing AF and the incidence of new-onset perioperative AF among older patients undergoing surgery for hip fractures.
Method:
A retrospective analysis of patients aged 60 years and above who presented with hip fractures requiring surgical intervention. Patient data, including demographics, comorbidities and AF status, were collected from medical records. Pre-existing AF was identified from the admission ECG and previous ECGs. New-onset peri-operative AF was defined as AF/flutter detected during or after surgery in patients with no prior history of AF.
Results: Number of patients: 102, Age range: 60–99 years; Median age: 85 years
Gender distribution: Male: 28 patients(27.5%), Female: 74 patients(72.5%)
Pre-existing atrial AF: 23 patients(22.5%), New-onset AF(intra- or post-operative): 10 patients(9.8%)
Total AF cases (pre-existing + new-onset): 33 patients(32.3%)
Patients requiring antiarrhythmic intervention (beta blockers or digoxin): 22 patients(21.5%)
Conclusion: Atrial fibrillation, both pre-existing and new-onset, is highly prevalent in older hip fracture patients, affecting over 30% of the cohort. These findings underscore the need for close cardiac monitoring, especially in the immediate peri-operative period, and consideration of rate control and anticoagulation strategies where appropriate. Proactive perioperative cardiac evaluation and management protocols are critical to optimizing outcomes in this high risk population.
Keywords: Atrial fibrillation, hip fracture, older, perioperative arrhythmia, cardiac risk, orthopaedic surgery
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