Predictive factors of hospital stay, mortality and functional recovery after surgery for hip fracture in elderly patients

• Published in: Revista española de cirugía ortopédica y traumatología 2017-11, Vol.61 (6), p.427-435
• Main Authors: Pareja Sierra, T., Bartolomé Martín, I., Rodríguez Solís, J., Bárcena Goitiandia, L., Torralba González de Suso, M., Morales Sanz, M.D., Hornillos Calvo, M.
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Aged, 80 and over; Anciano; Elderly; Evolución funcional; Factores pronósticos; Female; Ferroterapia intravenosa; Follow-Up Studies; Fractura de cadera; Fracture Fixation; Functional recovery; Hip fracture; Hip Fractures - mortality; Hip Fractures - physiopathology; Hip Fractures - surgery; Humans; Intravenous iron; Length of Stay - statistics & numerical data; Linear Models; Logistic Models; Male; Nutritional supplements; Osteoporotic Fractures - mortality; Osteoporotic Fractures - physiopathology; Osteoporotic Fractures - surgery; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Prognostic factors; Prospective Studies; Recovery of Function; Risk Factors; Suplementos nutricionales; Treatment Outcome
• ISSN: 1988-8856; 1988-8856
• DOI: 10.1016/j.recote.2017.10.007

Due to its high prevalence and serious consequences it is very important to be well aware of factors that might be related to medical complications, mortality, hospital stay and functional recovery in elderly patients with hip fracture. A prospective study of a group of 130 patients aged over 75 years admitted for osteoporotic hip fracture. Their medical records, physical and cognitive status prior to the fall, fracture type and surgical treatment, medical complications and functional and social evolution after hospitalisation were evaluated. Patients with greater physical disability, more severe cognitive impairment and those who lived in a nursing home before the fracture had worse functional recovery after surgery. Treatment with intravenous iron to reduce transfusions reduced hospital stay and improved walking ability. Infections and heart failure were the most frequent medical complications and were related to a longer hospital stay. The prescription of nutritional supplements for the patients with real indication improved their physical recovery after the hip fracture. Evaluation of physical, cognitive and social status prior to hip fracture should be the basis of an individual treatment plan because of its great prognostic value. Multidisciplinary teams with continuous monitoring of medical problems should prevent and treat complications as soon as possible. Intravenous iron and specific nutritional supplements can improve functional recovery six months after hip fracture. Analizar las características de los pacientes ingresados por fractura de cadera y su evolución 6 meses tras la cirugía para determinar los factores potencialmente relacionados con estancia hospitalaria, complicaciones médicas, mortalidad y recuperación funcional tras esta enfermedad tan prevalente y con graves consecuencias. Estudio prospectivo de un grupo de 130 pacientes mayores de 75 años hospitalizados por fractura de cadera de perfil osteoporótico. Se evaluaron sus antecedentes médicos, situación mental y física previas a la caída, tipos de fractura y tratamiento quirúrgico, complicaciones hospitalarias, así como evolución funcional y social tras la hospitalización. Los pacientes que tenían mayor grado de deterioro físico y mental previamente a la fractura y los institucionalizados tuvieron peor capacidad de recuperación tras la cirugía. El empleo de terapias alternativas a la transfusión para el tratamiento de la anemia se relacionó con disminución de estancia hospitalaria y