Influence of proximal femur fractures in the autonomy and mortality of elderly patients submitted to osteosynthesis with cephalomedullary nail

Abstract

ObjectiveTo determine the autonomy and mortality of elderly patients submitted to proximal femoral osteosynthesis with cephalomedullary nail after hip fracture.MethodsRetrospective study with 61 patients with proximal femoral fractures submitted to cephalomedullary nail osteosynthesis. The authors analyzed the medical records and collected information from the preoperative period. Patients were questioned regarding pain, postoperative autonomy, and degree of satisfaction. The total number of deaths was verified. The results were then correlated.ResultsThe mean age was 84 years, predominantly female (82%). In the postoperative evaluation, 45% of the patients presented worsened levels of autonomy. The majority of patients presented mild pain (61%) on the VAS scale. The mortality rate was 24.6%, and the mean time of preoperative hospitalization was three days. The factors that presented statistical significance regarding postoperative autonomy were the time elapsed from the trauma until the moment of surgery, ASA score, fracture stability, and previous functional status of the patients. The mortality rate was associated with three main factors: advanced age, ASA score, and preoperative hospitalization time.ConclusionThe patient's previous autonomy positively influenced the functional outcome and postoperative recovery. Unstable fractures presented worse results for pain and ambulation in a follow-up of 27 months. Hip fracture is a risk factor associated with mortality and decreased independence in patients over 65 years of age.

Blood Orders and Predictors for Hemotransfusion in Elective Femur Fracture Repair Surgery

“…17,25 However, studies that excluded patients under the age of 60 obtained higher means. [19][20] A study conducted in China showed lower mean weight (58.83±11.01 kg) than that in the present study, which can be related to the physical characteristics of Chinese individuals. Cardiovascular disease, associated with mortality and rehospitalization rates, was the main comorbidity found in this and other similar studies.…”

“…The predominance of female patients submitted to femur fracture repair surgery observed in this study is corroborated by other recent studies. 12,[15][16][17][18][19][20] Osteoporosis, falls from standing height as a mechanism of injury, exposure to more house chores, greater prevalence of chronic disease, and more fragile physical structure make the female gender more susceptible to this type of fracture. [21][22][23][24] Regarding mean patient age, similar results have been found by studies that evaluated populations in the same age group as those in the present study.…”

Long-term functional outcome after a low-energy hip fracture in elderly patients

“…Several studies have reported that significantly fewer elderly patients were walking independently at 1 to 4.9 years after hip fracture [10–12, 27, 28]. Kammerlander et al found that only 8% of the survivors were able to walk without the use of walking aids at a 4.9-year follow-up [11].…”

Optimizing osteoporosis care in a rural primary health care center: Findings of a research study aimed to support seniors

“…Also, approximately 50% of older adults who lived independently before sustaining a hip fracture are unable to regain their independent lifestyle; instead, they face ongoing disability and prolonged institutionalization. Alarmingly, 1‐year mortality rates after hip fracture range from 15% to 25% …”

“…Alarmingly, 1-year mortality rates after hip fracture range from 15% to 25%. 9 The strong relationship between low bone mass and risk of fracture has been well documented. 3,[10][11][12][13][14] Whereas osteoporosis in postmenopausal women is a well-recognized and extensively investigated health problem, there is a paucity of research on the effects of osteoporosis for older men.…”