Fisioterapia no pós-operatório de fratura proximal do fêmur em idosos: Revisão da literatura

Carneiro, Mariana Barquet; Alves, Débora Pinheiro Lédio; Mercadante, Marcelo Tomanik

doi:10.1590/s1413-78522013000300010

Cited by 33 publications

(18 citation statements)

References 20 publications

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“…With the population aging globally, hip fractures, often known as the “last fracture of life”, have become a common disease threatening the health of the elderly. The incidence of hip fracture in the elderly was 1.7 million in 1990 and is estimated to reach 6.3 million in 2050 [ 1 ]. Approximately two thirds of elderly patients with hip fractures lost their self-care ability in their daily life [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Elderly patients with concurrent hip fracture and lower respiratory tract infection: the pathogens and prognosis over different bedridden periods

et al. 2021

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Background Elderly patients who experience hip fractures often become bedridden and are at risk of developing lower respiratory tract infections. The current study was to investigate the etiology and bacterial drug resistance patterns of elderly patients with hip fractures and lower respiratory tract infections on prolonged bedridden time and to determine their prognosis. Methods Patients diagnosed with hip fractures admitted from May 2015 to April 2017 were included. The basic characteristics including the patients’ gender, age, fracture type, operation mode, bedridden duration, length of hospital stay, prognosis, past medical history, routine bloodwork, C-reactive protein (CRP), procalcitonin (PCT), blood biochemistry, blood gas analysis, glycosylated hemoglobin (HbA1C%), sputum smear, sputum culture, and anti-infection and related therapy were recorded. All patients were classified into three groups based on bed rest duration, including short-term (<1 month), mid-term (1–12 months), and long-term (> 12 months). The correlation between the bedridden time and the patients’ basic characteristics, disease history, laboratory examination results, pathogen, anti-infection, and related therapy were evaluated. The risk factors related to the prognosis of the disease were investigated. Results Prolonged bed rest in patients led to an increase in hospitalization time, mortality rates, and decreased serum albumin levels (P < 0.05). Sputum bacteriological culture results showed that, with bed rest prolongation, the proportion of Pseudomonas aeruginosa and fungal infections increased. Binomial logistic regression of pulmonary infection prognosis, glucocorticoid use during the anti-infective period, prolonged bedridden time, and serum albumin level showed that intravenous use of glucocorticoid during anti-infective treatment, bed rest > 1 year, and low serum albumin level were related to poor prognosis. Conclusion Elderly hip fracture patients with prolonged bedridden time had an increased chance of opportunistic pulmonary infection and decreased nutritional status. Glucocorticoids should be used cautiously.

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Section: Introductionmentioning

confidence: 99%

Elderly patients with concurrent hip fracture and lower respiratory tract infection: the pathogens and prognosis over different bedridden periods

et al. 2021

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“…The incidence of hip fracture in the elderly has risen rapidly from 1.7 million in 1990 to an estimated 6.3 million in 2050 worldwide. [ 1 ] Disability, defined as loss or impairment of baseline daily performance after the fracture event, has been reported in two-thirds of this group of patients. [ 2 ] After surgery for hip fracture repair, higher rates of serious complications from pulmonary disorders such as pneumonia, atelectasis, and pulmonary thromboembolism have been reported in patients older than 60 years.…”

Section: Introductionmentioning

confidence: 99%

Reduction in the incidence of pneumonia in elderly patients after hip fracture surgery

Chang

Lai²,

et al. 2018

Medicine

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Hip fracture is an important health care issue in the elderly. Postoperative pulmonary complications occur in 4% of patients after hip fracture surgery. However, previous research is limited regarding pulmonary rehabilitation in this group. In this study, we present clinical evidence regarding the impact of a comprehensive pulmonary rehabilitation program in elderly hip fracture patients after hip surgery.We designed a nonrandomized, Quasi-experimental study, comparing 2 sequential time periods in the same center. Elderly patients (≥65 years) with a new hip fracture from February 1, 2014 to December 31, 2015 and who were willing to undergo a postoperative pulmonary rehabilitation program were enrolled. The pulmonary rehabilitation program started on January 1, 2015. Patients who refused rehabilitation or did not receive a surgical intervention were excluded. Patients received either standard care (standard care group) or standard care plus the postoperative rehabilitation program (intervention group).A total of 240 patients (163 women and 77 men) were enrolled, including 138 in the standard care group and 102 in the intervention group. The intervention group had a significantly lower incidence of pneumonia (6 patients, 5.9%) compared to the standard care group (19 patients, 13.9%). An age >80 years, cancer status, and not undergoing the postoperative pulmonary rehabilitation program were factors associated with a higher risk of pneumonia. In multivariate analysis, age >80 years, history of stroke/cancer, thrombocytopenia, and hyperglycemia (>200 mg/dL) were identified as risk factors for pneumonia.The incidence of pneumonia was lower in the elderly patients with hip fractures who received the postoperative pulmonary rehabilitation program after surgery. This is the first trial to demonstrate the effect of a postoperative pulmonary rehabilitation program in hip surgery patients.

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“…3 This review reminds us engaging in practice change, which requires an assessment of those interventions that are supported by evidence. For instance, the targeted change in clinical practice could include a particular intervention such as using tranexamic acid in knee arthroplasty, 12 hip arthroplasty, 13 and spine surgery 14 to reduce postoperative bleeding or a proposed practice change could involve a bundle of evidence-based practices applicable to a group of patients; treatment of elderly patients with hip fractures should consider the evidence for the type of implant, 15 use of closed suction drains, 16 anesthetic choice including pain management, 17 rehabilitation strategies, 18,19 the perioperative medical management, 20 and finally when to start medication to prevent subsequent fractures. 21…”

Section: Discussionmentioning

confidence: 99%

What Systematic Reviews Exist for the Effectiveness of Orthopaedic Interventions

et al. 2019

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Introduction: Orthopaedics procedures are frequent and expensive, but highly cost effective in improving the quality of life. The purpose of this study was to determine the number and topics of systematic overviews on the effectiveness of orthopaedic interventions. Methods: We performed a review of PubMed, Ovid Embase, Scopus, OrthoEvidence, and the Cochrane Library for dates of publication from January 1, 2006, to February 3, 2017, to identify systematic overviews of randomized clinical trials for the effectiveness of therapeutic interventions involving orthopaedic surgeons. Abstracts were excluded based on the following sequentially applied criteria: (1) the systematic review did not include an intervention for an orthopaedic condition; the intervention was not therapeutic; the intervention was not likely to be applied or influenced by an orthopaedic surgeon; (2) the study was not a systematic review or the study was a single randomized controlled trial, and/or it included nonhuman studies; (3) the systematic review included nonrandomized studies; and (4) the systematic review did not state moderate or strong evidence in support of the study conclusion(s). Results: Of the 6,864 abstracts found in the searches, 6,145 were excluded yielding 719 systematic overviews. Contrary to conventional wisdom, this study identified 719 reviews of randomized controlled trials of therapeutic orthopaedic interventions. The interventions were classified as surgical in 383 (55%), medication in 245 (34%), and rehabilitation in 42 (6%), and other nonsurgical interventions in 39 (5%). Discussion: This study identified many systematic overviews of orthopaedic interventions. The findings of this study could both influence clinical practice and, given the frequency of orthopaedic procedures, have a major public health impact.

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Fisioterapia no pós-operatório de fratura proximal do fêmur em idosos: Revisão da literatura

Cited by 33 publications

References 20 publications

Elderly patients with concurrent hip fracture and lower respiratory tract infection: the pathogens and prognosis over different bedridden periods

Elderly patients with concurrent hip fracture and lower respiratory tract infection: the pathogens and prognosis over different bedridden periods

Reduction in the incidence of pneumonia in elderly patients after hip fracture surgery

What Systematic Reviews Exist for the Effectiveness of Orthopaedic Interventions

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