O perfil das internações do SUS para fratura osteoporótica de fêmur em idosos no Brasil: uma descrição do triênio 2006-2008

Abstract

A osteoporose é uma síndrome multifatorial do esqueleto, sendo a fratura de fêmur a mais séria consequência para idosos, devido à alta mortalidade e ao custo. Este trabalho descreveu as fraturas osteoporóticas de fêmur em idosos para o Brasil, no triênio 2006-2008. A Autorização de Internação Hospitalar (AIH) foi utilizada como base secundária de dados e permitiu criar indicadores para fratura de fêmur em idosos. As proporções de idosos internados no Sistema Único de Saúde (SUS) por esta causa chegaram a 1%. Os percentuais de internação e óbitos foram maiores no sexo feminino e aumentaram com a idade. Os gastos foram de aproximadamente 2% dos gastos do SUS para pessoas com 60 anos ou mais. A maioria das internações durou de um a sete dias; 50,1% ocorreram em hospitais filantrópicos; e 42,7% aconteceram fora do município de residência. Os resultados reforçam a necessidade de maior atenção para a osteoporose e mostram a relevância dos gastos públicos com internações de idosos por fratura osteoporótica de fêmur. A compreensão de tais internações auxilia a formulação de políticas de saúde para esta causa.

Epidemiology of Femur Fractures in the Elderly and Cost to the State of Paraná, Brazil

“…7,8 Total expenditures on hospitalization for femoral fractures in the elderly in Brazil were around 40 million R$ per year in the threeyear period of 2006-2008, representing about 2% of all causes of hospitalization among the elderly. 9 Driven by the absence of data on osteoporotic femoral fractures in the State of Paraná and the need to know the magnitude of the problem and its costs to the public health care system (SUS), the present study aims to assess the incidence and economic impact that this morbidity represented for the state in the period from January 2010 to December 2014.…”

Characterizing the fall and association between functional independence and balance in the elderly following proximal femoral surgery

“…It was also found that, between the ages of 60-85 years, the risk of fracture doubled for each 5-6 years of life [28]. It is emphasized that it is in the age group ≥ 80 years in which there also exists a greater chance of the elderly dying [4], indicating the need to work even harder to prevent fractures and on the recovery of functional independence in this group of patients.…”

“…It is known that these diseases cause the reduction of physical capacity that may cause effects on postural control of the individual in general, effecting the dynamic equilibrium, and therefore end up being a risk factor for falls [29,4]. A comparison of the scores of the FIM of the elderly with and without disease in these systems was also significant in the fields self-care, mobility/transfer, communication and social cognitive.…”

“…Falling in the elderly should be considered sentinel events in the life of an individual, potentially marking the initiation of an important decline in his functional capacity [2]. The consequences include: a loss of confidence with walking due to the fear of a new fall episode, in such a way that the elderly decrease their mobility; increase in dependence; injuries such as bruises, cuts and fractures, including proximal femoral fractures [1][2][3][4].…”

“…Within Brazil, one percent of the hospitalized elderly with an osteoporotic fracture who were seen in the Sistema Único de Saúde (Unified Health System: SUS), between 2006 and 2008, presented with a proximal femoral fracture as the primary diagnosis [4]. That said, these proximal femoral fractures in the elderly present different rates of mortality that vary according to advanced age, masculine gender, higher number of comorbidities, and severity [5].…”