Fratura do quadril: avaliação pós-operatória do resultado clínico e funcional

Guerra, Marcelo Teodoro Ezequiel; Thober, Thomas Alexandre; Bigolin, André Vicente; Souza, Marcos Paulo de; Echeveste, Simone Soares

doi:10.1590/s0102-36162010000600012

Cited by 7 publications

(9 citation statements)

References 27 publications

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“…In our study, we concluded that ASA score is a 1-year mortality risk factor only for operated subjects, as previously reported by several researchers [19,20,[23][24][25]. In many publications in which subjects were treated surgically and were classified as having an ASA score of III or IV, the expected survival rate after 1 year is 79.75% [32], and we found a survival rate in these ASA scores of 81.63% (ASA III) and 50% (ASA IV).…”

Section: Discussionsupporting

confidence: 89%

“…In this cohort, other characteristics such as type of fracture, gender and the presence or not of comorbidities were not found as risk factors for 1-year mortality as related in other studies in which only surgical treatment was chosen and all ASA scores were analyzed [13,16,18,22,23].…”

Section: Discussionmentioning

confidence: 75%

“…Although these articles have certain divergent opinions, none of them, and no other paper, referred to the relation- Hospital Stay as a Protective Factor for Hip Fracture J Curr Surg. 2016;6(1): [21][22][23][24][25][26][27][28][29] ship between hospitalization time and mortality rate for nonoperated patients. We believe that our study is the first to report this relation in elderly subjects with a hip fracture treated by the non-surgical method.…”

Section: Discussionmentioning

confidence: 99%

“…Several risk factors, such as male gender [13,[16][17][18][19][20][21], comorbidities [22], surgery delay [1,13,15], older age [13, 18, Hospital Stay as a Protective Factor for Hip Fracture J Curr Surg. 2016;6(1): 21-29 23] and an elevated ASA score (American Society of Anesthesiologists physical status classification system) [19,20,[23][24][25], are associated with 1-year mortality for operated patients, but few studies in the current literature [5,13,14,26] describe the risk factors for non-operated patients. Is the overall mortality rate in non-operated patients classified at ASA III-IV the same as that observed in operated patients classified at ASA III-IV?…”

Section: Introductionmentioning

confidence: 99%

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Length of Hospitalization: A Protective Factor in a Prospective Observational Cohort Study in Brazilian ASA III and IV Hip Fracture Elderly Patients

et al. 2016

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Background: Hip fracture is a devastating injury in elderly and the vast majorities are usually treated surgically. However, this treatment can also be non-operative, principally for patients classified at ASA III-IV. Several risk factors are associated with 1-year mortality for operated patients but a small number of studies provide the risk factors for non-operated patients. The aim of this study was to investigate the influence of hospitalization time and other risk factors on nonoperated patients. Methods: A prospective observational cohort study from April 2005 to April 2012 was conducted on 286 patients aged 65 years or more with hip fracture classified at ASA III-IV for 1 year to investigate the influence of hospitalization time and the 1-year mortality risk factors. Survival time was analyzed by Kaplan-Meier curves and Cox's regression models were used to evaluate risk factors to all subjects, operated and non-operated subjects. Results: The mortality was 73.5% for non-operated subjects. Final Cox's regression for all subjects demonstrated that for patients that do not undergo surgery, mortality increased by six times. To operated patients, for each day of hospitalization, 1-year survival decreased 12.6 days, and ASA IV increased the mortality rate three times. To non-operated subjects, hospitalization time was a protective factor; for each day of hospitalization, 1-year survival increased 10.44 days. Conclusion: When conservative treatment is chosen for a complicated elderly, extended hospitalization should be considered. Hospitalization time has proved to be a protective factor in these cases and discharge with improved survival rates with good clinical status should be advocated. However, surgery should always be employed even for patients with poor clinical conditions.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Length of Hospitalization: A Protective Factor in a Prospective Observational Cohort Study in Brazilian ASA III and IV Hip Fracture Elderly Patients

et al. 2016

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“…Moreover, the prevalence of this injury is increasing as the population ages. Hip fractures have been associated with increased mortality ( 1 - 9 ), and several risk factors are associated with elevated rates of this injury, such as male gender ( 10 - 15 ), ASA (American Society of Anesthesiologists) score ( 10 , 12 , 13 ),, comorbidities ( 20 ), and increased age ( 13 , 14 , 16 , 19 , 21 ). Furthermore, the time between the insult and surgical repair has been associated with high mortality rates among hip fracture subjects ( 22 , 23 ).…”

Section: Introductionmentioning

confidence: 99%

Predictors of hip fracture mortality at a general hospital in South Brazil: an unacceptable surgical delay

Ribeiro¹,

Premaor²,

Larangeira³

et al. 2014

Clinics

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OBJECTIVE:Hip fractures have been associated with increased mortality in the elderly. Several risk factors such as the time between the insult and the surgical repair have been associated with hip fracture mortality. Nevertheless, the risk of delayed surgical repair remains controversial. Few studies have examined this issue in Brazil. The aim of this study was to study the risk factors for death one year after hip fracture and in-hospital stay at a tertiary hospital in South Brazil.METHODS:A prospective cohort study was carried out from April 2005 to April 2011 at a tertiary university hospital at Santa Maria, Brazil. Subjects admitted for hip fracture who were 65 years of age or older were followed for one year. Information about fracture type, age, gender, clinical comorbidities, time to surgery, discharge, and American Society of Anesthesiologists score were recorded. Death was evaluated during the hospital stay and at one year.RESULTS:Four hundred and eighteen subjects were included in the final analysis. Of these, 4.3% died in-hospital and 15.3% were dead at one year. Time to surgery, American Society of Anesthesiologists score, Ischemic Heart Disease, and in-hospital stay were associated with death at one year in the univariate analysis. The American Society of Anesthesiologists score and time to surgery were one-year mortality predictors in the final regression model. In-hospital death was associated with American Society of Anesthesiologists score and age.CONCLUSION:Time to surgery is worryingly high at the South Brazil tertiary public health center studied here. Surgical delay is a risk factor that has the potential to be modified to improve mortality.

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Injury specific trauma registry: Outcomes of a prospective cohort with proximal femur fractures

Ahmad

Muhammad

Habib

2019

Annals of Medicine and Surgery

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Background The elderly population is prone to hip fractures, and treating such patients to achieve good outcomes can be challenging. Collection of outcomes data can support clinicians to modify their treatment protocols and improve outcomes over time. The aim of this study is to compare different surgical procedures in patients with neck of femur and intertrochanteric fractures in terms of clinical, functional and radiological outcomes using injury-specific outcome scores. Methods The study data was derived from the existing single-center, prospective orthopaedic trauma registry initiated from July 2015. Functional, clinical and radiological outcomes were assessed using Modified Harris Hip Score and The Radiographic Union Score for Hip. Mean radiological outcome scores was compared by Mann-Whitney U test and deaths by Chi-square and Odds ratio. Results Of the total 138 patients, 53 (38%) were neck of femur and 85 (62%) Intertrochanteric fractures with fall as leading cause of injury. At 12 months follow-up, modified Harris Hip Score showed 67% excellent-good results in both dynamic hip screw (N = 6) and total hip replacement (N = 3) followed by 50% in intramedullary nail (N = 2). Hemiarthroplasty has fair-poor outcomes with significantly higher deaths as compared to other procedure groups ( p = 0.016). Radiological outcomes showed non-significant trend towards better outcomes in dynamic hip screw as compared to intramedullary nail ( p = 0.08). Conclusion Our 12 months follow-up data suggest that dynamic hip screw and total hip replacement have better clinical, functional outcomes followed by intramedullary nail. Hemiarthroplasty has fair-poor clinical and functional outcomes with significantly higher deaths as compared to other procedure groups.

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Fratura do quadril: avaliação pós-operatória do resultado clínico e funcional

Cited by 7 publications

References 27 publications

Length of Hospitalization: A Protective Factor in a Prospective Observational Cohort Study in Brazilian ASA III and IV Hip Fracture Elderly Patients

Length of Hospitalization: A Protective Factor in a Prospective Observational Cohort Study in Brazilian ASA III and IV Hip Fracture Elderly Patients

Predictors of hip fracture mortality at a general hospital in South Brazil: an unacceptable surgical delay

Injury specific trauma registry: Outcomes of a prospective cohort with proximal femur fractures

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