Impacto de la demencia en la supervivencia de los pacientes con fractura de cadera intervenidos mediante prótesis total y parcial

Abstract

Objetive: To carry out a comparative survival analysis of patients diagnosed with hip fractures (HF) in the Basque Health Service from 2010 to 2016 depending on whether or not they were diagnosed with dementia and the type of arthroplasty. Material and methods:Observational study (real world data) of survival. The data were obtained from the administrative and clinical databases of the Basque Health Service using the Oracle Business Intelligence (OBI) manager. All cases of femur neck fractures from 2010 to 2016 were analyzed in the Basque Health Service. A descriptive analysis was carried out to detect differences between groups according to previous diagnosis of dementia and type of prosthesis. The Kaplan-Meier method was used to obtain the survival curves and their comparison was made in pairs using the Achievement test. The adjusted risk of death for each group was analyzed with the Cox regression model. Results: 5,867 patients with CF were identified, being 1,131 patients without dementia and total prosthesis, 3,073 without dementia and partial prosthesis, 176 with dementia and total prosthesis and 1,487 with dementia and partial prosthesis. The median survival was 9.08 years, 3.79 years, 2.55 years, and 2.54 years respectively. The comparison of the survival curves was significant for all cases except between the last two groups. Using the first group as a reference, the odds ratio of death for the rest was 1.56, 2.27 and 2.37 respectively. When analyzing the risk of death only for patients with dementia, the type of prosthesis was not statistically significant. Conclusions: Dementia influences the survival curve of patients who undergo arthroplasty after a femur neck fracture, with those who undergo a total arthroplasty have a similar mortality rate as those who undergo partial arthroplasty.

Hip fracture treatment and complications after surgery

“…3 Therefore, they represent a public health problem due to their high incidence and their impact on mortality and loss of quality of life. 4 They are very common serious injuries that present with a substantially increasing incidence together with the growth and aging of the population.…”