Associação entre o tempo de espera para cirurgia e mortalidade em pacientes idosos com fratura da extremidade proximal do fêmur

• Ano de defesa: 2024
• Autor(a) principal: André Lourenço Pereira
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; Brasil; MEDICINA - FACULDADE DE MEDICINA; Programa de Pós-Graduação em Ciências Aplicadas à Cirurgia e à Oftalmologia; UFMG
• Palavras-chave em Português: Fratura da extremidade proximal do fêmur; Idosos; Tempo total de internação; Tempo de espera para cirurgia; Mortalidade; Fraturas Proximais do Fêmur; Idoso; Tempo de Internação; Liberação de Cirurgia
• Link de acesso: http://hdl.handle.net/1843/77942

Introduction: Fractures of the proximal femur in elderly patients present high morbidity and mortality, with an expected increase in incidence in the coming years. It is known that preoperative factors can influence the treatment outcome of these patients. Therefore, it is essential to adequately prepare these patients with the aim of performing surgery within 48 hours of the fracture. Surgery at the correct time is related to a shorter total length of stay, fewer complications and reduced mortality. Objectives: To evaluate whether the waiting time for surgery in elderly patients with fractures of the proximal femur has an impact on mortality in 30 days, 90 days and one year in a large tertiary hospital of the SUS in Belo Horizonte, Brazil. To evaluate whether the total length of hospital stay, type of surgery performed (hip replacement or osteosynthesis), ASA score, blood transfusion and preoperative echocardiogram have a correlation with mortality in the same period. Method: Observational, retrospective study, based on medical record analysis, which included patients over the age of 60 years treated surgically for fracture of the proximal femur in a large SUS hospital. Data were collected on comorbidities, ASA score, waiting time for surgery, total length of stay, type of surgery performed, postoperative transfusion of blood products and preoperative echocardiogram. Results: 222 patients were included in the study. Mortality at 30 days was 12.6%, 90 days was 25.2% and one year was 41.4%. The average waiting time for surgery was 5.4 days. There was no correlation between waiting time for surgery and mortality at 30 days, 90 days and one year. The total length of stay was 12.9 days and was correlated with an increase in 30-day mortality. Arthroplasty was correlated with an increase in 30-day mortality when compared to those who underwent osteosynthesis. ASA score and preoperative echocardiogram were related to mortality at 30 days, 90 days and one year. Blood transfusion did not correlate with mortality. Conclusion: The total length of hospital stay, the surgery performed, the ASA risk score and preoperative echocardiogram were related to increased mortality in elderly patients with fractures of the proximal femur. Waiting time for surgery and blood transfusion were not related to mortality in the study population. Key-words: proximal femoral fractures; fêmur; elderly; total length of stay; waiting time for surgery; mortality.