Edelmuth Stephanie Victoria Camargo Leão, Sorio Gabriella Nisimoto, Sprovieri Fabio Antonio Anversa, Gali Julio Cesar, Peron Sonia Ferrari
Faculdade de Ciências Médicas e da Saúde de Sorocaba, Pontifícia Universidade Católica de São Paulo, Sorocaba, SP, Brazil.
Rev Bras Ortop. 2018 Aug 2;53(5):543-551. doi: 10.1016/j.rboe.2018.07.014. eCollection 2018 Sep-Oct.
To analyze comorbidities and clinical complications, and to determine the factors associated with mortality rates of elderly patients admitted with a hip fracture in a tertiary public hospital.
Sixty-seven medical records were reviewed in a retrospective cohort study, including patients equal to or older than 65 years admitted to this institution for hip fracture between January 2014 and December 2014. The evaluated items constituted were the following: interval of time between fracture and hospital admission, time between admission and surgical procedure, comorbidities, clinical complications, type of orthopedic procedure, surgical risk, cardiac risk, and patient outcome.
The average patients' age in the sample was 77.6 years, with a predominance of the female gender. Most patients (50.7%) had two or more comorbidities. The main clinical complications during hospitalization included cognitive behavioral disorders, respiratory infection and of the urinary tract. The times between fracture and admission and between admission and surgery were more than seven days in most of cases. The mortality rate during hospitalization was 11.9%, and was directly connected to the presence of infections during hospital stay ( = 0.006), to time between admission and surgery longer than seven days ( = 0.005), to the Goldman Cardiac Risk Index class III ( = 0.008), and to age equal to or greater than 85 years ( = 0.031).
Patients with hip fractures generally present comorbidities, are susceptible to clinical complications, and have an 11.9% mortality rate.
分析合并症及临床并发症，并确定三级公立医院收治的髋部骨折老年患者死亡率的相关因素。
在一项回顾性队列研究中，对67份病历进行了审查，其中包括2014年1月至2014年12月期间因髋部骨折入住本院的65岁及以上患者。评估项目包括：骨折与入院之间的时间间隔、入院与手术之间的时间、合并症、临床并发症、骨科手术类型、手术风险、心脏风险和患者预后。
样本中患者的平均年龄为77.6岁，女性占多数。大多数患者（50.7%）有两种或更多合并症。住院期间的主要临床并发症包括认知行为障碍、呼吸道感染和泌尿系统感染。大多数情况下，骨折与入院之间以及入院与手术之间的时间超过七天。住院期间的死亡率为11.9%，与住院期间感染的存在（P = 0.006）、入院与手术之间的时间超过七天（P = 0.005）、Goldman心脏风险指数III级（P = 0.008）以及年龄等于或大于85岁（P = 0.031）直接相关。
髋部骨折患者通常存在合并症，易发生临床并发症，死亡率为11.9%。
