Download PDF
CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(04): 552-559
DOI: 10.1055/s-0040-1713762
Artigo Original
Quadril

The Impact of Hip Fractures in the Public Health System in Brazil (SUS) 2008 - 2017: The Orthopedist Task

Article in several languages: português | English
Bernardo Stolnicki 
1   Setor de Doenças Osteometabólicas, Departamento de Ortopedia, Hospital Federal de Ipanema, Rio de Janeiro, RJ, Brasil
,
Bruno Casaes Teixeira
2   Amgen Biotecnologia do Brasil Ltda, São Paulo, SP, Brasil
3   Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brasil
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Objective The present study intends to describe the profile of hospitalization and ambulatory rehabilitation of patients ≥ 50 years old due to hip fracture in the Brazilian Public Health System (SUS, in the Portuguese acronym).

Methods This is a cross-sectional study of patients hospitalized due to hip fracture in the SUS between 2008 and 2017. Data included 441,787 hip fracture-related hospitalizations from the hospitalization database of the department of informatics of the Brazilian Unified Health System (SIH/DATASUS, in the Portuguese acronym), and data of patients who underwent rehabilitation from the ambulatory database of the department of informatics of the Brazilian Unified Health System (SIA/DATASUS, in the Portuguese acronym.).

Results Most of hip fracture-related hospitalizations (83.5%) happen to people ≥ 50 years old, with an average annual growth of 5.6% in hip fracture-related hospitalizations. The costs for the government have been growing in the same proportion and reached almost BRL 130 million in 2017, although with a 13.6% decrease in average cost per hospitalization. Besides the financial impact, hip fractures result in an in-hospital mortality rate around 5.0% in patients aged ≥ 50 years old. In addition, the percentage of patients that have undergone hip fracture-related rehabilitation increased from 2008 (14.0%) to 2012 (40.0%), and remained stable after that.

Conclusions The progressive increase in the incidence of hip fractures shows the financial and social impact, and the need for immediate actions to prevent this rising trend. Hip fractures are a risk for secondary fractures, the prevention is crucial, and the orthopedist plays a central role in this process.

Keywords

hip fractures - rehabilitation - datasus - secondary prevention

Financial Support

There was no financial support from public, commercial, or non-profit sources.


Study developed at the Osteometabolic Diseases Sector, Orthopedics Department, Hospital Federal de Ipanema, Rio de Janeiro, RJ, Brazil.




Publication History

Received: 14 October 2019

Accepted: 15 April 2020

Article published online:
30 September 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revinter Publicações Ltda
Rio de Janeiro, Brazil

 

  • Referências

  • 1 Abrahamsen B, van Staa T, Ariely R, Olson M, Cooper C. Excess mortality following hip fracture: a systematic epidemiological review. Osteoporos Int 2009; 20 (10) 1633-1650
    CrossrefPubMedSearch in Google Scholar
  • 2 Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. Lancet 2002; 359 (9319): 1761-1767
    Search in Google Scholar
  • 3 Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 2009; 301 (05) 513-521
    CrossrefPubMedSearch in Google Scholar
  • 4 Lawrence TM, Wenn R, Boulton CT, Moran CG. Age-specific incidence of first and second fractures of the hip. J Bone Joint Surg Br 2010; 92 (02) 258-261
    CrossrefPubMedSearch in Google Scholar
  • 5 Johnell O, Kanis JA, Odén A. et al. Fracture risk following an osteoporotic fracture. Osteoporos Int 2004; 15 (03) 175-179
    CrossrefPubMedSearch in Google Scholar
  • 6 Stolnicki B, Oliveira LG. Para que a primeira fratura seja a última. Rev Bras Ortop 2016; 51 (02) 121-126
    CrossrefPubMedSearch in Google Scholar
  • 7 Vaile J, Sullivan L, Bennett C, Bleasel J. First fracture project: addressing the osteoporosis care gap. Intern Med J 2007; 37 (10) 717-720
    CrossrefPubMedSearch in Google Scholar
  • 8 Hartholt KA, Lee R, Burns ER, van Beeck EF. Mortality from falls among US adults aged 75 years or older, 2000-2016. JAMA 2019; 321 (21) 2131-2133
    CrossrefPubMedSearch in Google Scholar
  • 9 Beaupre LA, Binder EF, Cameron ID. et al. Maximising functional recovery following hip fracture in frail seniors. Best Pract Res Clin Rheumatol 2013; 27 (06) 771-788
    CrossrefPubMedSearch in Google Scholar
  • 10 Wu D, Zhu X, Zhang S. Effect of home-based rehabilitation for hip fracture: A meta-analysis of randomized controlled trials. J Rehabil Med 2018; 50 (06) 481-486
    CrossrefPubMedSearch in Google Scholar
  • 11 Pinheiro MdeM, Eis SR. Epidemiology of osteoporotic fractures in Brazil: what we have and what we need. Arq Bras Endocrinol Metabol 2010; 54 (02) 164-170
    CrossrefPubMedSearch in Google Scholar
  • 12 Edelmuth SV, Sorio GN, Sprovieri FA, Gali JC, Peron SF. Comorbidades, intercorrências clínicas e fatores associados à mortalidade em pacientes idosos internados por fratura de quadril. Rev Bras Ortop 2018; 53 (05) 543-551
    CrossrefPubMedSearch in Google Scholar
  • 13 Hungria Neto JS, Dias CR, Almeida JD. Características epidemiológicas e causas da fratura do terço proximal do fêmur em idosos. Rev Bras Ortop 2011; 46 (06) 660-667
    CrossrefPubMedSearch in Google Scholar
  • 14 Loures FB, Chaoubah A, Maciel VS, Paiva EP, Salgado PP, Netto ÁC. Cost-effectiveness of surgical treatment for hip fractures among the elderly in Brazil. Rev Bras Ortop 2015; 50 (01) 38-42
    Search in Google Scholar
  • 15 Soares DS, Mello LM, Silva AS, Martinez EZ, Nunes AA. Fraturas de fêmur em idosos no Brasil: análise espaço-temporal de 2008 a 2012. Cad Saude Publica 2014; 30 (12) 2669-2678
    CrossrefPubMedSearch in Google Scholar
  • 16 Brasil. Ministério da Saúde. Prevenção à osteoporose deve começar na infância, 2011
    PubMed
  • 17 Haentjens P, Autier P, Barette M, Boonen S. Belgian Hip Fracture Study Group. The economic cost of hip fractures among elderly women. A one-year, prospective, observational cohort study with matched-pair analysis. J Bone Joint Surg Am 2001; 83 (04) 493-500
    CrossrefPubMedSearch in Google Scholar
  • 18 IBGE. Projeção da população do Brasil e das Unidades da Federação, 2019
    PubMed
  • 19 Brauer CA, Coca-Perraillon M, Cutler DM, Rosen AB. Incidence and mortality of hip fractures in the United States. JAMA 2009; 302 (14) 1573-1579
    CrossrefPubMedSearch in Google Scholar
  • 20 Cooper C, Cole ZA, Holroyd CR. et al. IOF CSA Working Group on Fracture Epidemiology. Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int 2011; 22 (05) 1277-1288
    CrossrefPubMedSearch in Google Scholar
  • 21 Leslie WD, O'Donnell S, Jean S. et al. Osteoporosis Surveillance Expert Working Group. Trends in hip fracture rates in Canada. JAMA 2009; 302 (08) 883-889
    CrossrefPubMedSearch in Google Scholar
  • 22 Lewiecki EM, Wright NC, Curtis JR. et al. Hip fracture trends in the United States, 2002 to 2015. Osteoporos Int 2018; 29 (03) 717-722
    CrossrefPubMedSearch in Google Scholar
  • 23 Cranney A, Tugwell P, Wells G, Guyatt G. Osteoporosis Methodology Group and The Osteoporosis Research Advisory Group. Meta-analyses of therapies for postmenopausal osteoporosis. I. Systematic reviews of randomized trials in osteoporosis: introduction and methodology. Endocr Rev 2002; 23 (04) 496-507
    CrossrefPubMedSearch in Google Scholar
  • 24 Kothawala P, Badamgarav E, Ryu S, Miller RM, Halbert RJ. Systematic review and meta-analysis of real-world adherence to drug therapy for osteoporosis. Mayo Clin Proc 2007; 82 (12) 1493-1501
    CrossrefPubMedSearch in Google Scholar
  • 25 International Osteoporosis Foundation (IOF). Capture the Fracture – Map of Best Practice. Disponível em: https://www.capturethefracture.org
  • 26 Marsh D, Åkesson K, Beaton DE. et al. IOF CSA Fracture Working Group. Coordinator-based systems for secondary prevention in fragility fracture patients. Osteoporos Int 2011; 22 (07) 2051-2065
    CrossrefPubMedSearch in Google Scholar
  • 27 Agência Nacional de Saúde Suplementar (ANS). Beneficiários de planos privados de saúde, por cobertura assistencial (Brasil – 2009–2019); 2019
    PubMed
  • 28 Viswanathan M, Reddy S, Berkman N. et al. Screening to Prevent Osteoporotic Fractures: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2018; 319 (24) 2532-2551
    CrossrefPubMedSearch in Google Scholar
  • 29 Albergaria BH, Chalem M, Clark P, Messina OD, Pereira RMR, Vidal LF. Consensus statement: osteoporosis prevention and treatment in Latin America-current structure and future directions. Arch Osteoporos 2018; 13 (01) 90-90
    CrossrefPubMedSearch in Google Scholar