3 years ago

Análise da morbimortalidade dos pacientes com fraturas peritrocantéricas tratadas cirurgicamente com haste intramedular de fêmur proximal

Sidney Quintas, Henrique Mansur, Jacques Charlab, Max Ramos

Publication date: Available online 21 May 2018

Source: Revista Brasileira de Ortopedia

Author(s): Sidney Quintas, Henrique Mansur, Jacques Charlab, Max Ramos

Resumo
Objetivo

Analisar a morbimortalidade dos pacientes com fraturas peritrocantéricas tratadas com haste intramedular e sua relação com o tempo de internação, com o tempo para fazer o procedimento cirúrgico e as comorbidades dos pacientes.

Métodos

Foi feito um estudo observacional, analítico e retrospectivo por meio da avaliação dos dados dos prontuários de 74 pacientes submetidos ao tratamento cirúrgico de fraturas peritrocantéricas com haste intramedular de fêmur proximal de 2011 a 2014 em uma unidade hospitalar.

Resultados

A idade média no momento da ocorrência da fratura foi de 79,7 anos e o tempo de internação total médio foi de 16,7 dias, com média de 11,3 dias até a cirurgia e 5,4 dias da cirurgia à alta. A incidência de complicações na internação no grupo com idade ≥ 78,5 anos foi de 47,6%, enquanto no grupo mais novo foi de 19,4% (p = 0,013). A incidência de complicações na internação no grupo que fez a cirurgia após seis dias foi significativamente maior (42,9%; p = 0,019). Foi observado também que a incidência de complicação na internação está significativamente associada ao risco cirúrgico ≥ 3 (p = 0,001) e à diabetes mellitus (p = 0,001).

Conclusão

As complicações relacionadas às fraturas peritrocantéricas estão significativamente associadas ao risco cirúrgico elevado (graus três e quatro), diabetes mellitus, idade (˃ 78,5 anos) e tempo de internação pré‐operatório prolongado (˃ 6 dias).

Abstract
Objective

To analyzes the morbidity and mortality of patients with pertrochanteric fractures treated with intramedullary nailing and their relation to the length of hospital stay, the time to perform the surgical procedure, and the patients’ comorbidities.

Methods

An observational, analytic, and retrospective study was carried out through the evaluation of the medical records data of a total of 74 patients who underwent surgical treatment of peritrochanteric fractures with intramedullary proximal femoral nail during the period from 2011 to 2014 in a hospital unit.

Results

The mean age at the moment of the fracture was 79.7 years and the mean total hospitalization time was 16.7 days, with an average of 11.3 days until surgery and 5.4 days after surgery at discharge. The incidence of complications during hospitalization in the group with age greater than or equal to 78.5 years was 47.6%, while in the younger group it was 19.4% (p = 0.013). The incidence of hospitalization complications in the group that underwent surgery over six days after the fracture was significantly higher, 42.9% (p = 0.019). It was also observed that the incidence of complications during hospitalization is significantly associated with cardiac risk index ≥ 3 (p = 0.001) and diabetes mellitus (p = 0.001).

Conclusion

Complications related to pertrochanteric fractures are significantly related with high cardiac risk index (grades 3 and 4), diabetes mellitus, age (˃ 78.5), and prolonged preoperative hospitalization time (˃ 6 days).

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