LAUSR

Population ageing is widespread across the world. It is most advanced in the most highly developed countries. According to United Nations, the proportion of the world’s population aged 60 years or over increased from 8% in 1950 to 12% in 2013, and will increase more rapidly in the next four decades to reach 21% in 2050. Older adults are closely related with bone loss and decreased bone mineral density, which increase fracture risks. Fracture risk in older is also medicated by central nervous system. Because the degradation of the nervous system functions, the elderly are easy to fall. Accordingly, the older fracture population increased annually. Older patients with fracture are always related with high mortality. A population-based study showed overall one-year postoperative mortality in hip fracture patients aged 65 was 27.3% and mortality after hip fracture at the end of the follow-up was 79.0%, which was 3-fold higher than that of the general population. Among older patients with orthopaedic surgery, the most common cause of death was circulatory diseases. Urban et al. reported one year incidence of postoperative myocardial infarction in an orthopaedic population was 0.6%, and 6.5% of those patients were at risk of cardiac event. Hietala P et al. found there were 35.5% asymptomatic myocardial infarctions in patients undergoing hip fracture surgery, and he believed perioperative myocardial infarctions were common and often unrecognized in these patients. Troponin I has emerged as the biomarker of choice for the detection of myocardial injury, being a more sensitive and specific marker compared to CK and CK-MB. Chong C et al. have already found elevated post-operative troponin levels were predictive of one-year survival in older patients undergoing emergency orthopaedic surgery. The purpose of the present study was to assess the relationship between perioperative elevation of Troponin I and one-year survival after orthopaedic surgery in older patients with fracture.