Time to death in a prospective cohort of 252 patients treated for fracture of the proximal femur in a major hospital in Portugal

Campos, Sónia; Alves, Sandra Maria Ferreira; Carvalho, Marília Sá; Nevès, Nuno; Trigo-Cabral, Abel; Pina, Maria de Fátima de

doi:10.1590/0102-311x00077714

Cited by 8 publications

(13 citation statements)

References 36 publications

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“…Thus, the finding that the risk of death is four times higher in patients with at least one type of comorbidity compared with those with no comorbidities is considered relevant, and it confirms data from Guerra et al, 13 who observed that the absence of comorbidities is associated with their so-called alive group, and that the presence of three comorbidities is associated with their so-called death group. The same occurs with Shebubakar et al 29 and with Campos et al, 30 who demonstrated that the presence of ≥ 2 comorbidities is associated with an increase in morbidity and mortality rates. Also regarding the choice for a purely quantitative analysis, we also consider that one of our goals was to create a line of reasoning that is reproducible and applicable to the general population, and not to specific groups and to their different levels of pathological involvement (patients with heart, coronary heart, liver disease, kidney or lung diseases, etc.).…”

Section: Discussionsupporting

confidence: 72%

“…Desta maneira, consideramos relevante o achado que demostra o risco de morte quatro vezes maior em pacientes com ao menos um tipo de comorbidade em comparação aos que não possuem comorbidades, corroborando Guerra et al, 13 que observou que a ausência de comorbidade é associada ao grupo de seu trabalho intitulado vivo e a presença de três comorbidades associada ao grupo intitulado óbito . O mesmo ocorre com Shebubakar et al 29 e Campos et al, 30 que demonstram que a presença de duas ou mais comorbidades está associada a um aumento da taxa de morbidade e mortalidade. Ainda no que diz respeito à escolha por uma análise puramente quantitativa, também levamos em consideração o fato de termos como objetivo a criação de uma linha de raciocínio reprodutível e aplicável à população de maneira geral e não a grupos específicos e seus distintos níveis de acometimento patológico (cardiopatas, coronariopatas, hepatopatas, nefropatas, pneumopatas, etc).…”

Section: Discussionunclassified

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Fatores preditivos de morte após cirurgia para tratamento de fratura proximal do fêmur

Loures¹

2019

Rev Bras Ortop

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Resumo Objetivo Avaliar fatores preditivos de morte em pacientes de idade igual ou superior a 70 anos com fratura proximal do fêmur submetidos a tratamento cirúrgico. Métodos Análise de prontuários médicos criando-se uma coorte retrospectiva com seguimento de 6 meses. Foram analisados 124 prontuários após aplicação dos critérios de inclusão e exclusão. Todos os pacientes foram tratados por um único cirurgião ortopédico em condições de uniformidade. Resultados Taxa de mortalidade de 34.7%, sendo o perfil mais comum de paciente o indivíduo do gênero feminino, com 85 anos e ao menos 1 comorbidade. Os pacientes com idade superior a 85 anos, internação hospitalar por mais de 7 dias, ao menos 1 comorbidade presente e internação em centro de terapia intensiva (CTI) apresentaram maior risco de óbito (respectivamente 2; 2,5; 4 e 4 vezes maior). Conclusão Em relação ao desfecho óbito, apesar de não encontramos diferença estatisticamente significativa no que se refere à topografia da lesão e como essas se comportam no momento em que coexistem junto a internação em CTI, acreditamos na necessidade de maiores investigações sob essa ótica na população com o perfil estudado.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionunclassified

Fatores preditivos de morte após cirurgia para tratamento de fratura proximal do fêmur

Loures¹

2019

Rev Bras Ortop

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“…Even if stated by individual authors that no OA was observed when this last group was used as control, one cannot exclude both the influence of the fracture itself and the possible influence of concomitant milder undiagnosed forms of OA. Patients affected with proximal femur fractures are elderly subjects, which can be affected by milder forms of hip OA, with local and systemic biochemical changes before the time a radiological diagnosis of hip OA is made [ 42 ]. Also, fractures, due to the inherent aggression, are associated with both a local and a systemic biochemical response, with an increased inflammatory response [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

“…Also, fractures, due to the inherent aggression, are associated with both a local and a systemic biochemical response, with an increased inflammatory response [ 43 ]. Both undiagnosed hip OA and the fracture-associated inflammatory reaction can lead to an underestimation of the neuroimmune activation in patients with hip OA, which represents an import bias in these comparisons [ 42 ]. Furthermore, it is known that expression of individual molecules changes along OA progression.…”

Section: Discussionmentioning

confidence: 99%

Neuroimmune expression in hip osteoarthritis: a systematic review

Silva

Linhares

Vasconcelos

et al. 2017

BMC Musculoskelet Disord

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BackgroundNeuroimmune axis is central in the physiopathology of hip osteoarthritis (OA), but its specific pathways are still unclear. This systematic review aims to assess the nervous and immune system profile of patients with hip osteoarthritis (OA) when compared to healthy controls.MethodsA systematic review followed PRISMA guidelines was conducted. A two-step selection process was completed, and from 609 references 17 were included. The inclusion criteria were: original articles on adult patients with hip OA, with assessment of neuroimmune expression. Articles with other interventions prior to analysis and those without a control group were excluded.ResultsThirty-nine relevant neuroimmune markers were identified, with assessments in bone, cartilage, synovial membrane, synovial fluid, whole blood, serum and/or immune cells. GM-CSF, IFN-γ, IL-1α, IL-6, IL-8, IL-1 and TNF-α presented variable expression among tissues studied when compared between hip OA and controls. VEGFs and TGF-ß isoforms showed similar tendencies among tissues and studies. On nervous expression, CGRP, Tuj-1 and SP were increased in synovial membrane. Overall, patients with hip OA presented a higher number of overexpressed markers.ConclusionsFor the first time a systematic review on neuroimmune expression in patients with hip OA found an upregulation of neuroimmune markers, with deregulated balance between pro and anti-inflammatory cytokines. However, no clear systematic pattern was found, and few information is available on nervous expression. This highlights the importance of future research with clear methodologies to guide the management of these patients.Electronic supplementary materialThe online version of this article (10.1186/s12891-017-1755-2) contains supplementary material, which is available to authorized users.

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“…Older male patients with a lower cognitive status had a higher chance of developing postoperative delirium (Raspopovic et al). Campos et al (2015) examined the one year survival rate and mortality predictors in patients with fracture of the proximal femur. Survival was assessed at three, six, nine and 12 months after fracture and repair.…”

Section: Mortality Risk After Hip Fracturementioning

confidence: 99%

What Are the Factors Contributing to the Delay in Hip Fracture Repair?

Padraic¹

2017

Preprint

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Hip fracture injuries are identified as one of the most serious healthcare problems affecting older adults (CDC). The prognosis after hip fracture is unfavorable and approximately 25% of elderly patients will die within one year after the event. Surgical repair is a critical element in the management of a hip fracture. Delay of surgery prolongs hospital stay and increases the risk of medical complications. Despite evidence showing early time to surgery reduces morbidity and mortality for patients with hip fractures, time delays to surgery still exist. The purpose of this quality improvement project was to explore patient-and hospital-specific barriers to early surgery for older adults with hip fractures in a community hospital. Kathleen Stevens' ACE Star Model was used as a conceptual framework to guide this project. A retrospective chart review was conducted with a total of 62 charts consisting of 55 females and 8 males who experienced a hip fracture. Data collected included age, gender, time from emergency room arrival to admission, time from admission to operative intervention, current medications on admission, current use of tobacco and alcohol, type of surgical intervention, and length of stay. Average length of time from admission to surgery was 29 hours. Eight charts were identified with a delay of greater than 48 hours to surgery.Patient-specific barriers were identified. Further research is indicated to determine hospital-specific barriers to early surgery.

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Time to death in a prospective cohort of 252 patients treated for fracture of the proximal femur in a major hospital in Portugal

Cited by 8 publications

References 36 publications

Fatores preditivos de morte após cirurgia para tratamento de fratura proximal do fêmur

Fatores preditivos de morte após cirurgia para tratamento de fratura proximal do fêmur

Neuroimmune expression in hip osteoarthritis: a systematic review

What Are the Factors Contributing to the Delay in Hip Fracture Repair?

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