Temporal Analysis of Elderly Femur Fractures Due to Bone Fragility in the Last Decade in Brazil, Considering the Period of the Covid-19 Pandemic

Abstract

BACKGROUNDOsteoporosis, a multifactorial disease linked to senility, contributes to femur fractures caused by falls as a result of bone fragility, with a high incidence of mortality. This study analyzed 10 years of hospitalizations for femur fractures in elderly patients, with a special view of 2020 and 2021, a critical period of the COVID-19 pandemic. METHODSTime series ecological study, using the Health Information System (TABNET), made available by the Department of Informatics of the Unified Health System (DATASUS), in June 2022. In hospital morbidity, the number of hospitalizations and mortality rate were evaluated, with filters for the Chapter ICD-10: XIX, including the falls, and ICD-10 Morb List: femur fracture, aged 60 or more, during January 2012 to December 2021 in Brazil. RESULTSFrom 2012 to 2021, there were a total of 533,938 hospital admissions for femur fractures among the population over 60 years old and an average mortality rate of 5.16% per year. The data showed an increasing pattern on the number of admissions each year, with an annual average increase of 6.39%. In 2020, the first year of the COVID-19 pandemic, the hospitalizations records were slightly smaller when compared to 2019 (-0.05%). However, in 2021 there was an increase of 8.69% (5,470 cases) when compared to 2020, a number 2.3% higher than the annual average for the decade analyzed. Yet, the mortality rate during the pandemic was maintained in both years (5.25%), standing slightly above the historical average (5.16%), but below the maximum observed during the decade (5.29% in 2017). CONCLUSIONThe reduction of bone density, resulting from physiological alterations of aging, is associated with a higher risk of falls and fractures. Falls in the elderly are a public health issue with significant physical, psychological and social consequences. Although the method does not allow inferences, it is postulated that the lower number of hospitalizations in 2020 is due to the changes in the healthcare system to deal with the emerging disease. With the prolonged period of confinement, differences in physical abilities, worsening of balance and worsening of muscle condition, begin to be observed. This physical deconditioning increases the risk of a fall, resulting in the data for 2021.