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[圣保罗市髋部骨折老年人群的高病亡率及骨质疏松症诊断水平降低]

[High morbid-mortability and reduced level of osteoporosis diagnosis among elderly people who had hip fractures in São Paulo City].

作者信息

Fortes Erika M, Raffaelli Maurício P, Bracco Oswaldo L, Takata Edmilson T T, Reis Fernando B, Santili Cláudio, Lazaretti-Castro Marise

机构信息

Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.

出版信息

Arq Bras Endocrinol Metabol. 2008 Oct;52(7):1106-14. doi: 10.1590/s0004-27302008000700006.

Abstract

OBJECTIVE

To know the morbid-mortality following an osteoporotic hip fracture in elderly patients living in São Paulo.

PATIENTS AND METHODS

This study evaluated prospectively all patient over 60 years admitted in 2 school-hospitals in the city of São Paulo in a following 6-month period due to a osteoporotic proximal femur fracture. All of them filled up the Health Assessment Questionnaire (HAQ) and had their chart reviewed. After 6 months they were re-interviewed. Linear regression analysis was utilized to determine the factors related to functional ability.

RESULTS

56 patients were included (mean age 80.7 +/- 7.9 years old, 80.4% females). After the 6-month follow up the mortality rate was 23.2%. Only 30% of the patients returned to their previous activities, and 11.6% became totally dependent. Factors related to worse functional ability after fracture were HAQ before fracture, institutionalization after fracture and age (r(2) 0.482). The diagnosis of osteoporosis was informed only by 13.9% of them, and just 11.6% received any treatment for that.

CONCLUSION

Our results showed the great impact of these fractures on mortality and in the functional ability of these patients. Nevertheless, many of our physicians do not inform the patients about the diagnosis of osteoporosis and, consequently, the treatment of this condition is jeopardized.

摘要

目的

了解圣保罗市老年患者骨质疏松性髋部骨折后的病死情况。

患者与方法

本研究前瞻性评估了圣保罗市两家教学医院在接下来6个月内收治的所有60岁以上因骨质疏松性股骨近端骨折入院的患者。他们均填写了健康评估问卷(HAQ)并接受病历审查。6个月后对他们进行再次访谈。采用线性回归分析确定与功能能力相关的因素。

结果

纳入56例患者(平均年龄80.7±7.9岁,女性占80.4%)。6个月随访后死亡率为23.2%。只有30%的患者恢复到之前的活动状态,11.6%的患者完全依赖他人。骨折后功能能力较差的相关因素为骨折前的HAQ、骨折后住院以及年龄(r²=0.482)。只有13.9%的患者被告知骨质疏松的诊断,仅有11.6%的患者接受了相关治疗。

结论

我们的结果显示这些骨折对患者死亡率和功能能力有很大影响。然而,我们的许多医生并未告知患者骨质疏松的诊断情况,因此,这种疾病的治疗受到了影响。

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