Daniachi Daniel, Netto Alfredo Dos Santos, Ono Nelson Keiske, Guimarães Rodrigo Pereira, Polesello Giancarlo Cavalli, Honda Emerson Kiyoshi
Department of Orthopedics and Traumatology, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.
Rev Bras Ortop. 2015 Jun 27;50(4):371-7. doi: 10.1016/j.rboe.2015.06.007. eCollection 2015 Jul-Aug.
This was an epidemiological study on fractures of the proximal third of the femur in elderly patients who were treated at a teaching hospital in the central region of São Paulo.
The subjects were patients over the age of 60 years who were attended over a 1-year period. A questionnaire seeking basic sociodemographic data and information on comorbidities presented and medications used was drawn up. The circumstances of the fractures and their characteristics, the treatment instituted and the intra-hospital mortality rate were evaluated.
The 113 patients included in the study presented a mean age of 79 years. The ratio between the sexes was three women to each man. Only 30.4% of the patients reported having osteoporosis and only 0.9% had had treatment for the disease. Low-energy trauma was the cause of 92.9% of the fractures. Femoral neck fractures accounted for 42.5% of the fractures and trochanteric fractures, 57.5%. Five patients did not undergo operations; 39 underwent joint replacement; and 69 underwent osteosynthesis. The mean length of hospital stay was 13.5 days and the mean length of waiting time until surgery was 7 days. The intra-hospital mortality rate was 7.1%.
The patients attended at this institution presented an epidemiological profile similar to what is found in the Brazilian literature. Chronic kidney failure is a significant factor with regard to intra-hospital mortality. Preventive measures such as early diagnosis and treatment of osteoporosis and regular physical activity practices were not implemented.
这是一项针对圣保罗中部地区一家教学医院收治的老年患者股骨近端三分之一骨折的流行病学研究。
研究对象为60岁以上且在1年期间就诊的患者。编制了一份问卷，以获取基本的社会人口统计学数据以及所呈现的合并症和所用药物的信息。评估了骨折的情况及其特征、所采取的治疗方法以及院内死亡率。
纳入研究的113例患者的平均年龄为79岁。男女比例为每1名男性对应3名女性。只有30.4%的患者报告患有骨质疏松症，且只有0.9%的患者接受过该疾病的治疗。92.9%的骨折由低能量创伤引起。股骨颈骨折占骨折病例的42.5%，转子间骨折占57.5%。5例患者未接受手术；39例接受了关节置换；69例接受了骨固定术。平均住院时间为13.5天，手术前的平均等待时间为7天。院内死亡率为7.1%。
在该机构就诊的患者呈现出与巴西文献中所发现的相似的流行病学特征。慢性肾衰竭是院内死亡的一个重要因素。未实施诸如骨质疏松症的早期诊断和治疗以及定期进行体育活动等预防措施。
