Correa José Guilherme Lollo, Andrade-Silva Fernando Brandão, Fortes Sileno, Kojima Kodi Edson, Silva Jorge Dos Santos, Leme Luiz Eugênio Garcez
Universidade de São Paulo, Medical School, Institute of Orthopedics and Traumatology, São Paulo, SP, Brazil.
Universidade de São Paulo, Medical School, Institute of Orthopedics and Traumatology, Trauma Group, São Paulo, SP, Brazil.
Acta Ortop Bras. 2020 Jan-Feb;28(1):40-43. doi: 10.1590/1413-785220202801215801.
To investigate the existence of a causal association between orthopedic treatment and the occurrence of in hospital death.
338 patients with proximal femoral fracture were evaluated, of whom 27 faced in hospital death. Patients who faced in hospital death (case group) were compared to patients who did not (control group) regarding exposure to risk factors prior to injury and factors related to orthopedic treatment.
The factors related to higher in hospital mortality rate were: male sex (case group: 52%, control: 26%; p = 0.005), lower Parker's score (case group: 5.0 points, control: 6.2; p = 0.048), delirium on admission (case group: 26%, control: 10%; p = 0.011); delirium developed during hospitalization (case group: 77%, control: 35%; p <0.001), and time until surgery (13.3 days, 9.1; p = 0.049).
The in hospital mortality rate of patients with proximal femoral fracture was 8%, and the main associated risk factors were male sex, reduced Parker's score, delirium diagnosed on hospital admission or developed during hospitalization, and time until surgery.
探讨骨科治疗与住院死亡之间是否存在因果关联。
对338例股骨近端骨折患者进行评估，其中27例患者在住院期间死亡。将住院期间死亡的患者（病例组）与未死亡的患者（对照组）在受伤前的危险因素暴露情况及与骨科治疗相关的因素方面进行比较。
与较高住院死亡率相关的因素包括：男性（病例组：52%，对照组：26%；p = 0.005）、较低的帕克评分（病例组：5.0分，对照组：6.2分；p = 0.048）、入院时谵妄（病例组：26%，对照组：10%；p = 0.011）、住院期间出现谵妄（病例组：77%，对照组：35%；p <0.001）以及手术等待时间（13.3天，9.1天；p = 0.049）。
股骨近端骨折患者的住院死亡率为8%，主要相关危险因素为男性、帕克评分降低、入院时或住院期间诊断出的谵妄以及手术等待时间。
