CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2019; 54(04): 382-386
DOI: 10.1055/s-0039-1693667
Artigo Original | Original Article
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revnter Publicações Ltda Rio de Janeiro, Brazil

Evaluation of the Laboratorial Profile of Elderlies with Proximal Femur Fracture by Low Energy Mechanism[*]

Article in several languages: português | English
1   Hospital Regional de São José Dr. Homero de Miranda Gomes, São José, SC, Brasil
,
Daniel Teixeira de Oliveira
2   Cirurgia do Joelho, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
Renato Locks
1   Hospital Regional de São José Dr. Homero de Miranda Gomes, São José, SC, Brasil
› Author Affiliations
Further Information

Publication History

21 March 2018

17 July 2018

Publication Date:
20 August 2019 (online)

Abstract

Objective This study aims to evaluate the laboratory results profile of elderly patients with proximal femoral fractures and to verify the relationship between these data, fracture outcome and death.

Methods Cross-sectional study of patients admitted to the orthopedic emergency service of a referral hospital between February and April 2017 with proximal femoral fracture by low energy mechanism and submitted to laboratorial and imaging tests. Patients with suspected or confirmed pathological fracture were excluded from the study.

Results Sixty-six individuals were evaluated, 44 of whom were women, all over 60 years old. Transtrochanteric fractures had the highest incidence in the study (36). Alterations of parathyroid hormone and albumin levels were significant for death (p ≤ 0.05). Length of hospital stay was not a significant factor for death.

Conclusions Laboratory abnormalities were not related to the outcome of death. Albumin may be related to the risk of death. No laboratory result was pointed out as a facilitator in the generation of proximal femoral fractures. More studies are needed to better understand the laboratory influence on fractures and their consequences.

* Work performed at Hospital Regional de São José Dr. Homero de Miranda Gomes, São José, SC, Brazil.


 
  • Referências

  • 1 Sakaki MH, Oliveira AR, Coelho FF, Leme LEG, Suzuki I, Amatuzzi MM. Estudo da mortalidade na fratura do fêmur proximal em idosos. Acta Ortop Bras 2004; 12 (04) 242-249
  • 2 Mesquita GV, Lima M, Santos AM, Alves EL, Brito JNPO, Martins MC. Morbimortalidade em idosos por fratura proximal do fêmur. Texto Contexto Enferm 2009; 18 (01) 67-73
  • 3 Astur DC, Arliani GG, Balbachevsky D, Fernandes HJ, Reis FB. Fratura da extremidade proximal do fêmur tratadas no Hospital São Paulo/Unifesp: estudo epidemiológico. Rev Bras Med 2013; 68 (04) 11-15
  • 4 Daniachi D, dos Santos Netto A, Ono NK, Guimarães RP, Polesello GC, Honda EK. Epidemiology of fractures of the proximal third of the femur in elderly patients. Rev Bras Ortop 2015; 50 (04) 371-377
  • 5 Rocha MA, Azer HW, Nascimento VDG. Evolução funcional nas fraturas da extremidade proximal do fêmur. Acta Ortop Bras 2009; 17 (01) 17-21
  • 6 Cauley JA, Lacroix AZ, Wu L, Horwitz M, Danielson ME, Bauer DC. , et al. Serum 25-hydroxyvitamin D concentrations and risk for hip fractures. Ann Intern Med 2008; 149 (04) 242-250
  • 7 Uzoigwe CE, Venkatesan M, Smith R, Burnand HG, Young PS, Cheesman CL. , et al. Serum lactate is a prognostic indicator in patients with hip fracture. Hip Int 2012; 22 (05) 580-584
  • 8 Li PF, Lin ZL, Pang ZH, Zeng YR. Does serum calcium relate to different types of hip fracture? A retrospective study. Chin J Traumatol 2016; 19 (05) 275-277
  • 9 Ramason R, Selvaganapathi N, Ismail NH, Wong WC, Rajamoney GN, Chong MS. Prevalence of vitamin d deficiency in patients with hip fracture seen in an orthogeriatric service in sunny singapore. Geriatr Orthop Surg Rehabil 2014; 5 (02) 82-86
  • 10 Madsen CM, Jørgensen HL, Lind B, Ogarrio HW, Riis T, Schwarz P. , et al. Secondary hyperparathyroidism and mortality in hip fracture patients compared to a control group from general practice. Injury 2012; 43 (07) 1052-1057
  • 11 Koval KJ, Maurer SG, Su ET, Aharonoff GB, Zuckerman JD. The effects of nutritional status on outcome after hip fracture. J Orthop Trauma 1999; 13 (03) 164-169
  • 12 Roddam AW, Neale R, Appleby P, Allen NE, Tipper S, Key TJ. Association between plasma 25-hydroxyvitamin D levels and fracture risk: the EPIC-Oxford study. Am J Epidemiol 2007; 166 (11) 1327-1336
  • 13 Larrosa M, Gomez A, Casado E, Moreno M, Vázquez I, Orellana C. , et al. Hypovitaminosis D as a risk factor of hip fracture severity. Osteoporos Int 2012; 23 (02) 607-614
  • 14 Guerra MT, Feron ET, Viana RD, Maboni J, Pastore SI, Castro CC. Elderly with proximal hip fracture present significantly lower levels of 25-hydroxyvitamin D. Rev Bras Ortop 2016; 51 (05) 583-588
  • 15 Gumieiro DN, Pereira GJ, Minicucci MF, Ricciardi CE, Damasceno ER, Funayama BS. Associations of vitamin D deficiency with postoperative gait and mortality among patients with fractures of the proximal femur. Rev Bras Ortop 2015; 50 (02) 153-158
  • 16 Di Monaco M, Vallero F, Di Monaco R, Tappero R, Cavanna A. 25-hydroxyvitamin D, parathyroid hormone, and functional recovery after hip fracture in elderly patients. J Bone Miner Metab 2006; 24 (01) 42-47
  • 17 Fisher A, Goh S, Srikusalanukul W, Davis M. Elevated serum PTH is independently associated with poor outcomes in older patients with hip fracture and vitamin D inadequacy. Calcif Tissue Int 2009; 85 (04) 301-309
  • 18 Grimes JP, Gregory PM, Noveck H, Butler MS, Carson JL. The effects of time-to-surgery on mortality and morbidity in patients following hip fracture. Am J Med 2002; 112 (09) 702-709
  • 19 Parker MJ, Handoll HH, Bhargara A. Conservative versus operative treatment for hip fractures. Cochrane Database Syst Rev 2000; (04) CD000337
  • 20 Holick MF. Vitamin D deficiency. N Engl J Med 2007; 357 (03) 266-281
  • 21 Chapuy MC, Arlot ME, Duboeuf F, Brun J, Crouzet B, Arnaud S. , et al. Vitamin D3 and calcium to prevent hip fractures in elderly women. N Engl J Med 1992; 327 (23) 1637-1642
  • 22 Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 2006; 84 (01) 18-28 . [Erratum. Am J Clin Nutr 2006;84:1253