Fractura de cadera en el adulto mayor: epidemiología y costos de la atención

Pech-Ciau, BA; Lima-Martínez, EA; Espinosa-Cruz, GA; Pacho-Aguilar, CR; Huchim-Lara, Oswaldo; Alejos-Gómez, RA

doi:10.35366/103314

Cited by 9 publications

(8 citation statements)

References 22 publications

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“…En la serie presentada se encontró que el mayor porcentaje de pacientes con FC fueron mujeres mayores de ochenta años. La distribución por sexo y grupo de edad fue similar a lo presentado por Pech cuando analizó 16 829 pacientes en México (14) . Sin embargo, en el Perú, Palomino y col. evaluaron 79 pacientes y encontraron una población menos envejecida (edad media de 66 años con un rango intercuartílico entre 65 -81) (15) .…”

Section: Discussionunclassified

Evaluación geriátrica integral en pacientes con fractura de cadera

Cieza-Macedo,

Oscanoa,

Montenegro-Saldaña

et al. 2023

An Fac med

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Introducción. Las fracturas de cadera son un conjunto de patologías frecuentes en los adultos mayores frágiles, con impacto negativo sobre la funcionalidad. Objetivo. Determinar las características clínicas, funcionales, mentales y sociales basados en la evaluación geriátrica integral. Métodos. Se evaluó a 445 pacientes, la comorbilidad se midió con el índice de Charlson, el estado funcional basal con el índice de Barthel y la escala de Lawton y Brody, el estado mental con el cuestionario de Pfeiffer, el delirio mediante el Confusion Assessment Method y la evaluación social con la Escala Sociofamiliar de Gijón. Las variables categóricas se presentaron como valor absoluto y porcentaje, y las continuas como media y desviación estándar. Resultados. El sexo femenino representó el 71,5%, el promedio de edad en mujeres fue de 81,58 años y en varones de 82,58 años. El deterioro visual fue 48,8% y el auditivo fue 46,1%. El 46,0% tuvieron más de una comorbilidad. 30,3% era independiente para actividades básicas, así como 90,3% de mujeres y 64,3% de hombres fueron dependientes para actividades instrumentales. El deterioro cognitivo estuvo presente en el 53,5% de los pacientes y delirio el 20,4%. En la segunda semana fueron operados 30,5% y en la tercera 21,6%. La mortalidad fue de 2,7% durante la hospitalización. Conclusión. Las características más frecuentes fueron de una octogenaria, con deterioro visual/auditivo, sin comorbilidad, pero pluripatológica, con dependencia leve para actividades básicas de vida diaria y deterioro cognitivo en entorno social de riesgo.

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Section: Discussionunclassified

Evaluación geriátrica integral en pacientes con fractura de cadera

Cieza-Macedo,

Oscanoa,

Montenegro-Saldaña

et al. 2023

An Fac med

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“…In our study, the male patients accounted for less, that was about 33.5%. Previous studies on hip fracture also showed that the proportion of males was relatively low, about 21%–27% 30,31 . Whether gender was a risk factor for death remained controversial 32 .…”

Section: Inflammation Predict Long‐term Mortality After Hip Fracture ...mentioning

confidence: 99%

Admission Inflammation Markers Influence Long‐term Mortality in Elderly Patients Undergoing Hip Fracture Surgery: A Retrospective Cohort Study

Long,

Yang,

Jin

et al. 2023

Orthopaedic Surgery

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ObjectivesHip fractures in elderly patients are associated with a high mortality rate. Most deaths associated with hip fracture result from complications after surgery. Recent studies suggest that some inflammation biomarkers may be useful to estimate excess mortality. This study aimed to investigate the prognostic value of admission inflammation biomarkers in elderly patients with hip fracture.MethodsWe reports on a retrospective study of elderly hip fracture patients admitted to a hospital in China between January 2015 and December 2019. A total of 1085 patients were included in the study, and their demographic and pre‐operative characteristics were analyzed. The inflammation biomarkers included monocyte to lymphocyte ratio (MLR), neutrophil to lymphocyte ratio (NLR), and C‐reactive protein (CRP) to albumin ratio (CAR). The predictive performance of NLR, MLR and CAR was assessed by receiver operating characteristics (ROC) curve analysis and the association between admission inflammation markers and mortality was evaluated by Cox proportional regression.ResultsThe 30‐day, 1‐year, 2‐year, and 4‐year mortality were 1.6%, 11.5%, 21.4% and 48.9%, respectively. The optimal cut‐off values of admission NLR, MLR and CAR for 1‐year mortality were 7.28, 0.76, and 1.36. After adjusting the covariates, preoperative NLR ≥ 7.28 (HR = 1.419, 95% CI: 1.080–1.864, p = 0.012) were found to be only independent risk factors with 4‐year all‐cause mortality, the preoperative CAR ≥ 1.36 was independently associated with 1‐year (HR = 1.700, 95% CI: 1.173–2.465, p = 0.005), 2 year (HR = 1.464, 95% CI: 1.107–1.936, p = 0.008), and 4‐year (HR = 1.341, 95% CI: 1.057–1.700, p = 0.016) all‐cause mortality, While age, CCI score, and low hemoglobin at admission were also risk factors for postoperative all‐cause mortality.ConclusionAdmission CAR and NLR may be useful indicators for predicting the long‐term mortality of elderly patients undergoing hip fracture surgery, and that more research is needed to validate these findings.

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“…Hip fracture is a common type of fracture in older people[ 1 ]. Traditional conservative treatment is prone to delay healing and cause muscle atrophy, joint stiffness, and other problems, seriously affecting the quality of life of elderly patients[ 2 ]. With the improvement of modern surgical technology, an increasing number of elderly patients with fractures choose surgical treatment[ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of ulinastatin combined with dexmedetomidine on cognitive dysfunction and emergence agitation in elderly patients who underwent total hip arthroplasty

Huo,

Zhu,

Guo

et al. 2024

World J Psychiatry

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BACKGROUND With the continuous growth of the modern elderly population, the risk of fracture increases. Hip fracture is a common type of fracture in older people. Total hip arthroplasty (THA) has significant advantages in relieving chronic pain and promoting the recovery of hip joint function. AIM To investigate the effect of ulinastatin combined with dexmedetomidine (Dex) on the incidences of postoperative cognitive dysfunction (POCD) and emergence agitation in elderly patients who underwent THA. METHODS A total of 397 patients who underwent THA from February 2019 to August 2022. We conducted a three-year retrospective cohort study in Shaanxi Provincial People’s Hospital. Comprehensive demographic data were obtained from the electronic medical record system. We collected preoperative, intraoperative, and postoperative data. One hundred twenty-nine patients who were administered Dex during the operation were included in the Dex group. One hundred fifty patients who were intravenously injected with ulinastatin 15 min before anesthesia induction were included in the ulinastatin group. One hundred eighteen patients who were administered ulinastatin combined with Dex during the operation were included in the Dex + ulinastatin group. The patients’ perioperative conditions, hemodynamic indexes, postoperative Mini-Mental State Examination (MMSE) scores, Ramsay score, incidence of POCD, and serum inflammatory cytokines were evaluated. RESULTS There was a significant difference in the 24 h visual analogue scale score among the three groups, and the score in the Dex + ulinastatin group was the lowest (P < 0.05). Compared with the Dex and ulinastatin group, the MMSE scores of the Dex + ulinastatin group were significantly increased at 1 and 7 d after the operation (all P < 0.05). Compared with those in the Dex and ulinastatin groups, incidence of POCD, levels of serum inflammatory cytokines in the Dex + ulinastatin group were significantly decreased at 1 and 7 d after the operation (all P < 0.05). The observer’s assessment of the alertness/sedation score and Ramsay score of the Dex + ulinastatin group were significantly different from those of the Dex and ulinastatin groups on the first day after the operation (all P < 0.05). CONCLUSION Ulinastatin combined with Dex can prevent the occurrence of POCD and emergence agitation in elderly patients undergoing THA.

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Fractura de cadera en el adulto mayor: epidemiología y costos de la atención

Abstract: Fractura de cadera en el adulto mayor: epidemiología y costos de la atención

Cited by 9 publications

References 22 publications

Evaluación geriátrica integral en pacientes con fractura de cadera

Evaluación geriátrica integral en pacientes con fractura de cadera

Admission Inflammation Markers Influence Long‐term Mortality in Elderly Patients Undergoing Hip Fracture Surgery: A Retrospective Cohort Study

Effects of ulinastatin combined with dexmedetomidine on cognitive dysfunction and emergence agitation in elderly patients who underwent total hip arthroplasty

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