Evaluation of the effectiveness of a care program for elderly patients with hip fractures: a network strategy

Abstract

Objective: Evaluate the effectiveness of a care program for elderly persons with hip fractures due to a fall, based on a public network in Canoas, Rio Grande do Sul, Brazil. Methods: a prospective cohort study of quantitative character was carried out. A total of 182 elderly person above 60 years diagnosed with hip fractures were included. The sample was divided into two groups, one who underwent their usual treatment (n=91) and another who were included in a care program for elderly persons with hip fractures (n=91). The program had as its main axis a clinical Protocol and an Access Protocol. The treatment of choice was surgical in all cases. In statistical analysis, categorical variables were described by absolute and relative frequencies. The Mann-Whitney test was used to compare numeric variables. In the comparison of proportions, the Pearson's Chi-squared test or Fisher's exact test were applied. The significance level adopted was 5%. Results: The average age was 79.4 years, with a prevalence of the female gender. The most frequent morbidity was hypertension. After the implementation of the program there was a reduction in the average time between the fracture and the beginning of surgery, the average length of hospitalization, the urinary tract infection rate, the death rate and care costs. Conclusion: The care program of elderly persons with hip fractures modified the expected results as it reduced mortality, average hospital stay, postoperative complications and the costs of treatment during the hospitalization.

Segurança do paciente idoso hospitalizado: uma análise do risco de quedas

“…In this regard, the older adults in this research who had a medical diagnosis of Diabetes Mellitus (DM) had a significant association with the high risk of falls. Research conducted with older adult patients hospitalized for hip fractures due to falls found diabetes mellitus in 23.1% of respondents, second only to hypertension (25) . In this perspective, it is necessary to maintain greater attention to these patients in view of the potential complications arising from the pathophysiology of this disease, such as nephropathy, retinopathy and injuries due to peripheral neuropathy.…”