Factores determinantes de estancia hospitalaria, mortalidad y evolución funcional tras cirugía por fractura de cadera en el anciano

Sierra, Teresa Pareja; Martín, Irene Bartolomé; Solís, Juan Rodríguez; Goitiandia, L. Bárcena; Torralba, Miguel; Sanz, María Dolores Morales; Calvo, M. Isabel Brincones

doi:10.1016/j.recot.2017.06.002

Cited by 10 publications

(5 citation statements)

References 29 publications

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“…Hence there would be a potential selection bias. Also, there are numerous factors which might affect the functional recovery including cognitive status, nutritional status or type of operation2223), but we did not evaluate the factors. Further study might be necessary to confirm the clinical finding of the current study.…”

Section: Discussionmentioning

confidence: 99%

Favorable Functional Recovery and Stem Stability after Hip Arthroplasty with a Short Metaphyseal Stem in Elderly Patients with Osteoporotic Femoral Neck Fractures

Lee

Yoon

2019

Hip & Pelvis

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PurposeShort stems have recently become widely used; however, concerns about the initial secure fixation of a short stem in osteoporotic bone remain. The aim of this study was to evaluate the short-term clinical and radiological results of using a short cementless metaphyseal stabilizing tapered stem for senile osteoporotic femoral neck fractures.Materials and MethodsThirty-eight arthroplasties (31 bipolar hemiarthroplasties and 7 total hip arthroplasties) were performed for osteoporotic femoral neck fractures in patients older than 65 years (10 males and 28 females). The mean age was 76.1 years and the mean follow-up was 2.9 years. We retrospectively evaluated clinical results, focusing on walking performance, thigh pain, and radiologic results, with special regard to signs of stem stability and osteointegration.ResultsMean Harris hip score was 84.3 points and 68.4% of patients regained their preoperative walking performance. No patients complained about thigh pain. No osteolysis or loosening was observed during the follow-up, and all but 1 stem showed signs of stable bone ingrowth.ConclusionShort, metaphyseal stabilizing tapered stems could be a reliable treatment option for osteoporotic femoral neck fractures.

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Section: Discussionmentioning

confidence: 99%

Favorable Functional Recovery and Stem Stability after Hip Arthroplasty with a Short Metaphyseal Stem in Elderly Patients with Osteoporotic Femoral Neck Fractures

Lee

Yoon

2019

Hip & Pelvis

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“…Especially, hip fractures are common and serious injuries of elderly people that lead to loss of mobility and independency and result in significant socioeconomic consequences [1,2]. Elderly patients with hip fractures often present with comorbidities and frequently suffer complications during their hospital stay [3]. In addition, patients become further debilitated by pain, loss of mobility, and quality of life [1].…”

Section: Introductionmentioning

confidence: 99%

“…A multidisciplinary postoperative approach and early ambulation have been identified to increase functional outcome at discharge and enhanced performance in activities of daily living after hip fracture [3,7,18–21]. In this context, the effect of postoperative weight bearing is still controversial although full weight bearing seems to be favored [22–25].…”

Section: Introductionmentioning

confidence: 99%

Influence of mobilization and weight bearing on in-hospital outcome in geriatric patients with hip fractures

Baer

Neuhaus

Pape

et al. 2019

SICOT-J

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Introduction: Early recovery of mobilization after a fracture of the hip is associated with improved long-term ability to walk, lower complication rates, and mortality. In this context, early mobilization and full weight bearing are favorable. The aim of this study was (1) to analyze the influence of time between operation and first mobilization on in-hospital outcome and (2) the influence of early mobilization, full weight bearing, and ASA on pain, mobility of the hip, and ability to walk during the in-hospital phase of recovery. Methods: This is a retrospective in-hospital study of 219 patients aged 70 years or older who were treated with surgery after a hip fracture. Data were collected by a review of medical records. The outcomes were mortality, complications, length of stay, and the Merle d’Aubigné score which evaluates pain, mobility of the hip, and ability to walk. Factors were sought in bivariate and multivariate analyses. Results: A shorter time between operation and first mobilization was significantly associated with lower in-hospital mortality and complications. Early mobilization (within 24 h after the operation) and full weight bearing had no influence on pain, mobility of the hip, and ability to walk as well as length of stay in our cohort. Fracture type and treatment influenced mobility of the hip, while age as well as physical health status affected the ability to walk. Discussion: Patients with femoral neck fractures, respectively after total hip arthroplasty, had less pain and showed better mobility of the hip and ability to walk during hospitalization than patients with trochanteric fractures; these results were irrespective of early vs. late mobilization and full vs. partial weight bearing. Foremost, a shorter time between operation and first mobilization is associated with lower complication and mortality rates.

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“…(9,10) En este estudio se encontraron diferencias significativas en la estadía hospitalaria entre ambos periodos, siendo la p de 0,04 por lo que se puede afectar en la reducción de la tasa de ISQ No se encontraron diferencias en la duración de la cirugía, que en ambos casos en promedio fue similar a lo reportado por la literatura. (11,12,13,14,15,16) En el caso de las cirugías de cadera, la antibioticoterapia profiláctica se utiliza para reducir el riesgo de infecciones en la cirugía. (17,18,19,20,21,22,23,24) En este estudio todos los antibióticos administrados fueron por vía intravenosa.…”

Section: Discussionunclassified

Implementation of protocol to reduce surgical site infections in arthroplasty with hip prosthesis

Gerez

2023

Salud, Ciencia y Tecnología

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Introduction: A surgical site infection (SSI) is a type of SSI that occurs after surgery in the area of the body where surgery is performed, involves the skin, tissues and organs and implant material, and has signs and symptoms of infection. The prevention of SSI should be a priority element for surgical services and health centers where preoperative, intraoperative and postoperative risk should be considered.Objective: To analyze the impact of the implementation of a protocol to reduce the incidence of surgical site infection in hip prosthesis arthroplasties, with the implementation of a protocol for ES decolonization and treatment of infections prior to surgery.Methods: An experimental type study was conducted, in which a pre-surgical protocol was applied, with a multidisciplinary team to reduce total hip prosthesis SSIs, comparing the pre-implementation period, from January to December 2017, with the period from January 2018 to December 2021.Results: the rate of SSI in the pre-implementation period was 22 % (10 cases), in the period that the intervention was performed 3% (2 cases). Disease motivating surgery: hip fracture: 50%, Osteoarthrosis: 49 %, hip dysplasia: 1%.Conclusions: In this study, the intervention was positive, a statistically significant reduction in the rate of SSI was found in the period after the implementation of the protocol with greater adherence to pre-surgical bathing, and the performance of SA decolonization, as well as hospital stay as a protective factor.

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Factores determinantes de estancia hospitalaria, mortalidad y evolución funcional tras cirugía por fractura de cadera en el anciano

Cited by 10 publications

References 29 publications

Favorable Functional Recovery and Stem Stability after Hip Arthroplasty with a Short Metaphyseal Stem in Elderly Patients with Osteoporotic Femoral Neck Fractures

Favorable Functional Recovery and Stem Stability after Hip Arthroplasty with a Short Metaphyseal Stem in Elderly Patients with Osteoporotic Femoral Neck Fractures

Influence of mobilization and weight bearing on in-hospital outcome in geriatric patients with hip fractures

Implementation of protocol to reduce surgical site infections in arthroplasty with hip prosthesis

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