Author(s): Vidal, Edison Iglesias de Oliveira [UNESP] ; Moreira Filho, Djalma de Carvalho ; Pinheiro, Rejane Sobrino ; Souza, Romulo Cristovão ; Almeida, Liz Maria de ; Camargo Jr., Kenneth Rochel de ; Boas, Paulo José Fortes Villas [UNESP] ; Fukushima, Fernanda Bono [UNESP] ; Coeli, Cláudia Medina
Date: 2016
Persistent ID: http://hdl.handle.net/11449/136850
Origin: Oasisbr
Subject(s): Hip fractures; Osteoporosis; Quality of health care; Developing countries; Brazil
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Objectives: To describe the clinical profile, patterns of care and mortality rates of aged patients who have undergone hip fracture surgical repair. Design: Retrospective patient record study. Setting: A public university hospital in Rio de Janeiro, Brazil. Participants: 352 patients aged 60 and older who underwent surgery for hip fracture between 1995-2000. Measurements: Sociodemographic data, type of fracture, cause of fracture, time from fracture to surgery, physical status, Charlson comorbidity index, type of surgery and anesthesia, access to in-hospital physiotherapy, use of antibiotic and thromboembolism prophylaxis, and mortality within one year after hospital admission. Results: Among 352 subjects, 74.4% were women. The mean age overall was 77.3 years. Very long delays from the time of fracture to hospital admission (mean 3 days) and from hospital admission to surgery (mean 13 days) were observed. Most femoral neck fractures (82.7%) were managed by hip arthroplasties, while 92.8% of the intertrochanteric fractures underwent internal fixation procedures. Less than 10% of patients received in-hospital physiotherapy. Mortality rates 30 days, 90 days and one year after hospital admission were 3.4%, 8.0% and 13.4%, respectively. Conclusion: Our study provides evidence within the context of a developing country of major gaps in the quality of care of vulnerable older adults who suffered a hip fracture. Our findings suggest that hip fracture has not been treated as an urgent condition or a priority within the Brazilian public healthcare system. Further research should address current patterns of care for hip fracture in Brazil and in other developing countries.
Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Faculdade de Medicina de Botucatu (FMB), Departamento de Clínica Médica, Botucatu, SP, Brasil
Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brasil
Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
Universidade Estadual do Rio de Janeiro (UERJ), Faculdade de Ciências Médicas, Rio de Janeiro, RJ, Brasil
Intituto Nacional do Câncer (INCA), Rio de Janeiro, RJ, Brasil
Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Faculdade de Medicina de Botucatu (FMB), Departamento de Anestesiologia, Botucatu, SP, Brasil
Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Faculdade de Medicina de Botucatu (FMB), Departamento de Clínica Médica, Botucatu, SP, Brasil
Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Faculdade de Medicina de Botucatu (FMB), Departamento de Anestesiologia, Botucatu, SP, Brasil
CNPq: 474845/2001-0
