Preoperative transthoracic echocardiogram and delay to geriatric hip fracture surgery

INTRODUCTION: Delays to surgery confer increased morbidity and mortality in elderly patients who have sustained hip fractures. Preoperative investigations including transthoracic echocardiography (TTE) are often requested. The aim of this study was to determine whether there were delays to surgery when these patients underwent preoperative TTE. METHODS: Electronic databases were searched from inception until April 2025. All relevant studies were identified with data extracted and meta-analysed. FINDINGS: = 0.03) shorter in those who did not receive a preoperative TTE. CONCLUSIONS: The available evidence did not demonstrate a statistically significant association between time to surgery and preoperative TTE. However, the data available are limited by heterogeneity, confounding and insufficient statistical power. In general, improving access to, and efficiency in TTE could help minimise delays to surgery, particularly in centres with limited resources. Strict adherence to American College of Cardiology guidelines for preoperative TTE indications is recommended.

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Publication Details

Journal
Annals of The Royal College of Surgeons of England
Published
2026-10-15
DOI
https://doi.org/10.1308/rcsann.2026.0086
Primary Topic
Hip and Femur Fractures
Type
article
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article

Preoperative transthoracic echocardiogram and delay to geriatric hip fracture surgery

M Symes, J Xu, K Muller, B Sivakumar et al.
Annals of The Royal College of Surgeons of England
Hip and Femur Fractures
article

Preoperative transthoracic echocardiogram and delay to geriatric hip fracture surgery

M Symes, J Xu, K Muller, B Sivakumar, F Pathan
article en

Abstract

INTRODUCTION: Delays to surgery confer increased morbidity and mortality in elderly patients who have sustained hip fractures. Preoperative investigations including transthoracic echocardiography (TTE) are often requested. The aim of this study was to determine whether there were delays to surgery when these patients underwent preoperative TTE. METHODS: Electronic databases were searched from inception until April 2025. All relevant studies were identified with data extracted and meta-analysed. FINDINGS: = 0.03) shorter in those who did not receive a preoperative TTE. CONCLUSIONS: The available evidence did not demonstrate a statistically significant association between time to surgery and preoperative TTE. However, the data available are limited by heterogeneity, confounding and insufficient statistical power. In general, improving access to, and efficiency in TTE could help minimise delays to surgery, particularly in centres with limited resources. Strict adherence to American College of Cardiology guidelines for preoperative TTE indications is recommended.

Annals of The Royal College of Surgeons of England
Sutherland Hospital (AU), Royal North Shore Hospital (AU), Hornsby Ku-ring-gai Hospital (AU), Nepean Hospital (AU), Lismore Base Hospital (AU), St George Hospital (AU)
Good health and well-being
Openalex Percentile: Top 10%
Hip and Femur Fractures
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