Características epidemiológicas e causas da fratura do terço proximal do fêmur em idosos

Neto, José Soares Hungria; Dias, Caio Roncon; Almeida, José Daniel Bula de

doi:10.1590/s0102-36162011000600007

Cited by 37 publications

(24 citation statements)

References 30 publications

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“…Studies published previously also showed that women and individuals of advanced age presented fractures of the proximal femur more frequently, because of their association with osteoporosis. 1 , 18 , 23 , 24 , 25 The side predominantly affected by these fractures was the right side.…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of treatment of transtrochanteric fractures with Dynamic Hip Screws using minimally invasive access

Abreu

Sena

Filho

2016

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveTo analyze the short-term results from treating unstable intertrochanteric fractures with Dynamic Hip Screws (DHS), using a minimally invasive route, focusing on the functional aspects and complication and mortality rates of the method.MethodsThis was a prospective longitudinal study on 140 patients who underwent fixation of transtrochanteric fractures with the DHS system with a lateral minimally invasive access in the hip, between January and December 2013. The patients were evaluated pre and postoperatively (after six months of follow-up) by means of the Parker and Palmer mobility score. Women comprised 65.7% of the sample, and 54.3% of the fractures were on the right side. The patients’ mean age was 80 years, ranging from 60 to 93 years.ResultsWe observed an overall decrease in the mobility score and an increase in the degree of dependence over the short term. However, we encountered only two deaths in the study sample and there were no cases of infection or nonunion.ConclusionDespite the efficacy of the treatment with DHS, with high rates of fracture consolidation and a low mortality rate, we noted that the patients still showed significant functional limitation at the follow-up six months after the operation.

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Section: Discussionmentioning

confidence: 99%

“…In the worldwide literature, we noted that, independent of the treatment method chosen, the time when the operation was performed or the previous level of autonomy, the patients’ degree of dependence increased considerably after surgical treatment. 23 , 30…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of treatment of transtrochanteric fractures with Dynamic Hip Screws using minimally invasive access

Abreu

Sena

Filho

2016

Revista Brasileira de Ortopedia (English Edition)

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“…6 A maior incidência de FQ em mulheres pode estar relacionada ao fato de o sexo feminino ter maior expectativa de vida e, portanto, estar mais exposto a fatores de risco, iniciar o processo de declínio de massa óssea antes do homem, ter maior suscetibilidade para quedas, além das influências antropométricas e dos fatores genéticos associados ao sexo. 7,13 Quando avaliada a média de idade, o resultado desta pesquisa foi de 79,4 anos (± 8,8), maior em comparação aos estudos feitos por Hungria Neto, Dias e Almeida, 14 com média de 75,8 anos, mas menor que o valor encontrado no banco de dados dos estudos epidemiológicos do Ministério da Saúde, 3 que fizeram referência à média de 83 anos. Todavia, os resultados aferidos estão em consenso com esta e outras análises, quando identificaram que há incidência maior de idosos com FQ na sétima e na oitava década de vida.…”

Section: Variáveis N Custo Total (R$) P** Mediana (P25 -P75)unclassified

“…15 Na classificação por tipos de fratura foram encontradas na amostra 83 (62%) fraturas transtrocantéricas e 51 (38%) fraturas de colo de fêmur, quantidades condizentes com a literatura. 1,6,8,14 A prevalência de comorbidades é alta entre os pacientes hospitalizados com FQ. 7 Idosos com fraturas por queda têm alta prevalência de comorbidades e elevado risco para complicações.…”

Section: Variáveis N Custo Total (R$) P** Mediana (P25 -P75)unclassified

Fatores determinantes dos custos dos tratamentos para idosos com fratura de quadril

Farias¹,

Terra²,

Brum³

et al. 2017

Geriatr., Gerontol. Aging

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RESUMOOBJETIVO: Avaliar os fatores associados aos custos hospitalares no tratamento de idosos com fratura de quadril (FQ) em um hospital público. MÉTODOS: Foi realizado um estudo de coorte retrospectivo de prontuários de um hospital público da Região Metropolitana de Porto Alegre (RS). Foram incluídos 134 prontuários de idosos com diagnóstico de FQ, internados no período de julho de 2014 a outubro de 2016. RESULTADOS: A idade dos idosos variou de 61 a 96 anos, com média de 79,4 anos (± 8,8). Houve predominância do gênero feminino (73,1%). O tempo médio de internação hospitalar foi de 13,87 dias. Na avaliação da presença de morbidades associadas, 56 (41,7%) apresentaram pelo menos uma morbidade, e 64 (47,7%), de duas a seis morbidades associadas. O custo médio das internações por paciente foi de R$ 9.390,21 (US$ 2.745). Na composição geral dos custos, os serviços de enfermagem, nutrição, hotelaria e limpeza, materiais, medicamentos e diárias representaram 78,3% dos gastos, seguidos pelas órteses e próteses (10,7%) e pelos honorários médicos (10%). Ocorreu associação significativa entre o tempo para iniciar a cirurgia e a média de permanência (p < 0,001), entre o tempo para dar início à cirurgia e os custos hospitalares (p < 0,001), e entre as comorbidades e os custos hospitalares (p < 0,001). CONCLUSÃO: Além dos custos diretos da assistência, foram identificados como fatores associados aos custos o número de morbidades, a média de permanência e o tempo para iniciar a cirurgia. Quanto maior o tempo entre a fratura e a cirurgia, maior foi o custo total. PALAVRAS-CHAVE: idoso; custos; fraturas do quadril. ABSTRACT OBJECTIVE:To evaluate associated factors with hospital costs in the treatment of elderly patients with hip fracture in a public hospital. METHODS: A retrospective cohort study of medical records from a public hospital in the metropolitan area of Porto Alegre (RS) was performed. They included 134 medical records of elderly patients with hip fracture diagnosis, hospitalized from July 2014 to October 2015. RESULTS: The age of patients ranged from 61 to 96 years old, with an average of 79.4 years (± 8.8). There was a predominance of the female gender (73.1%). The average length of hospital stay was 13.87 days. In assessing the presence of associated morbidities, 56 (41.7%) had at least one morbidity, and 64 (47.7%) had two to six associated morbidities. The average cost of hospitalization per patient was R$ 9.390.21 (US$ 2,745). At the general composition of costs, nursing and nutrition services, hostelry and cleaning materials, medicines and daily expenses accounted for 78.3% of the expenditures, followed by orthotics and prosthetics (10.7%) and medical fees (10%). There was a significant association between the time to start the surgery and the average length of stay (p < 0.001), between the time to start the surgery and hospital costs (p < 0.001), and between the sum of morbidity and hospital costs (p < 0.001). CONCLUSION: In addition to the direct costs, the comorbidities, the average residence time and th...

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“… 1 It occurs typically in individuals over the age of 60, especially in post-menopausal women, 2 usually due to low-energy trauma such as falls to the ground. 3 4 However, this type of fracture can also be observed in young patients and, in these cases, it relates to high-energy trauma such as automobile injuries. 5 6 …”

Section: Introductionmentioning

confidence: 99%

Influence of age on delayed surgical treatment of proximal femoral fractures

et al. 2015

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OBJECTIVE: To investigate the influence of patients' age on the delay between diagnosis and surgical treatment of proximal femoral fracturesMETHODS: This is a retrospective study, con-ducted at a tertiary university hospital, including all patients admitted with proximal femoral fractures between March 2013 and March 2014. The participants were categorized into four groups according to age levels. The groups were compared according to demographics, comorbidities, fracture type, trau-ma circumstances, and time between diagnosis and surgical procedureRESULTS: One hundred and sixty one patients were included, 37 adults and 124 elderly. Among adults, the mean delay between diagnosis and surgical procedure was 6.4±5.3 days; among elderly the delay was 9.5±7.6 days. There was a progressive increase in the delay from the young-adults group through the elderly individuals (Kruskal-Wallis: 13.7; p=0.003) CONCLUSION: In spite of being the patients most susceptible to complications due to surgical delay, the elderly individuals pre-sented the longest delays from admission to surgical treatment. Level of Evidence III, Retrospective Study.

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Características epidemiológicas e causas da fratura do terço proximal do fêmur em idosos

Cited by 37 publications

References 30 publications

Effectiveness of treatment of transtrochanteric fractures with Dynamic Hip Screws using minimally invasive access

Effectiveness of treatment of transtrochanteric fractures with Dynamic Hip Screws using minimally invasive access

Fatores determinantes dos custos dos tratamentos para idosos com fratura de quadril

Influence of age on delayed surgical treatment of proximal femoral fractures

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