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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(02): 222-230
DOI: 10.1055/s-0043-1768624
Artigo Original
Trauma

Fatores associados à reinternação em até 30 dias após a alta e à mortalidade intra-hospitalar após cirurgia por fratura do fêmur proximal em idosos: coorte retrospectiva[*]

Artikel in mehreren Sprachen: português | English
Alex Fabiano Dias Pinto 
1   Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brasil
,
Clarissa Moreira Teatini 
1   Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brasil
,
Núbia Carelli Pereira de Avelar 
2   Departamento de Ciências da Saúde, Universidade Federal de Santa Catarina. Araranguá, SC, Brasil
,
Amanda Aparecida Oliveira Leopoldino 
2   Departamento de Ciências da Saúde, Universidade Federal de Santa Catarina. Araranguá, SC, Brasil
,
Isabel Cristina Gomes Moura 
3   Programa de Pós-Graduação em Ciências da Saúde, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brasil
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Resumo

Objetivo Avaliar os fatores associados à reinternação em até 30 dias após a alta (R30) e à mortalidade intra-hospitalar (MIH) em idosos submetidos a cirurgia por fratura do fêmur proximal (FFP).

Métodos Coorte retrospectiva com dados de 896 prontuários de idosos (≥ 60 anos) submetidos a cirurgia de FFP em hospital brasileiro, no período entre novembro de 2014 a dezembro de 2019. Os pacientes incluídos foram acompanhados desde a data de internação para a cirurgia até 30 dias após a alta. Como variáveis independentes, foram avaliados o sexo, idade, estado civil, hemoglobina (Hb) pré e pós-operatória, razão normalizada internacional, tempo da internação relacionada à cirurgia, tempo porta cirurgia, comorbidades, cirurgias prévias, uso de medicamentos e escore da American Society of Anesthesiologists (ASA).

Resultados A incidência de R30 foi de 10,2% (intervalo de confiança [IC] 95%: 8,3–12,3%) e a de MIH foi 5,7% (IC95%: 4,3–7,4%). Referente a R30, no modelo ajustado, associaram-se ter hipertensão (odds ratio [OR]: 1,71; IC95%: 1,03–2,96), uso regular de medicamentos psicotrópicos (OR: 1,74; IC95%: 1,12–2,72). Tratando-se da MIH, maiores chances estiveram associadas à doença renal crônica (DRC) (OR: 5,80; IC95%: 2,64–12,31), maior tempo de internação (OR: 1,06; IC95%: 1,01–1,10) e R30 (OR: 3,60; IC95%: 1,54–7,96). Maiores valores de Hb pré-operatória associaram-se à menor chance de mortalidade (OR: 0,73; IC95%: 0,61–0,87).

Conclusão Os achados sugerem que a ocorrência destes desfechos está associada à comorbidades, medicamentos e Hb.

Palavras-chave

idoso - fraturas do fêmur - readmissão do paciente - mortalidade

* Trabalho desenvolvido no Departamento de Ciências da Saúde da Universidade Federal de Santa Catarina, Araranguá, SC, Brasil.




Publikationsverlauf

Eingereicht: 18. Februar 2022

Angenommen: 18. Oktober 2022

Artikel online veröffentlicht:
25. Mai 2023

© 2023. Sociedade Brasileira de Ortopedia e Traumatologia. 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/)

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