Publication: Tratamiento integral de la fractura de cadera en el anciano: modelo predictivo de mortalidad intrahospitalaria
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2017-02-17
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Universidad Complutense de Madrid
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Abstract
La fractura de cadera en el anciano, en su mayor parte de origen osteoporótico, es la causa más frecuente de ingreso en los servicios de Cirugía Ortopédica y Traumatología. A pesar de los programas de prevención, el número de ingresos por fractura de cadera aumentará en los próximos años debido al envejecimiento poblacional. Se trata de una patología no solo frecuente sino de notables consecuencias, como un aumento de morbilidad, un mayor deterioro funcional, un aumento del riesgo de institucionalización y conlleva un coste elevado para el sistema sanitario. Además, aumenta el riesgo de mortalidad, tanto intrahospitalaria, como tras el alta, incluso años después de sufrir la fractura. Aproximadamente un 5% de los pacientes ancianos que ingresan con fractura de cadera fallece en el hospital y hasta un 12% lo hace en el primer mes tras la fractura. Estudios previos, de metodología muy heterogénea, han investigado qué factores se relacionan con fallecer durante la hospitalización. Sin embargo, solo unos pocos han intentado modelizar esa relación con la intención de predecir mortalidad, es decir, construir un modelo estadístico con diferentes variables presentes al ingreso, para predecir el riesgo que tiene un paciente determinado de fallecer durante la hospitalización. Por este motivo, esta tesis doctoral tiene como objetivo desarrollar un modelo predictivo de mortalidad intrahospitalaria en pacientes ancianos que ingresan por fractura de cadera...
Hip fracture in elderly patients, mostly due to osteoporosis, is the most frequent cause of admission in Orthopedic Surgery services. Despite all preventive programs, the number of admissions due to hip fracture will increase in the foreseeable future owing to population ageing. Besides being rather common, this pathology also entails remarkable consequences such as a raise in morbidity, a greater functional impairment, and an increase risk in institutionalization, while also leading to a substantial cost for the health system. In addition, it raises the risk in both in-hospital and after-discharge mortality, even when some years have passed after the fracture. Around 5% of elderly patients admitted with a hip fracture die within the hospitalization, and up to a 12% die within the first month right after the fracture. Previous studies –which made use of a very heterogeneous methodology- have done some research into the factors related to death occurring during admission. Yet only a few have tried to create a mathematical model with the intention of predicting mortality, that is, to create an statistical model considering a number of variables present at admission, in order to predict the risk of dying during the hospitalization. For this reason, the PhD thesis aims at developing a predictive model of in-hospital mortality in elderly patients admitted with a hip fracture...
Hip fracture in elderly patients, mostly due to osteoporosis, is the most frequent cause of admission in Orthopedic Surgery services. Despite all preventive programs, the number of admissions due to hip fracture will increase in the foreseeable future owing to population ageing. Besides being rather common, this pathology also entails remarkable consequences such as a raise in morbidity, a greater functional impairment, and an increase risk in institutionalization, while also leading to a substantial cost for the health system. In addition, it raises the risk in both in-hospital and after-discharge mortality, even when some years have passed after the fracture. Around 5% of elderly patients admitted with a hip fracture die within the hospitalization, and up to a 12% die within the first month right after the fracture. Previous studies –which made use of a very heterogeneous methodology- have done some research into the factors related to death occurring during admission. Yet only a few have tried to create a mathematical model with the intention of predicting mortality, that is, to create an statistical model considering a number of variables present at admission, in order to predict the risk of dying during the hospitalization. For this reason, the PhD thesis aims at developing a predictive model of in-hospital mortality in elderly patients admitted with a hip fracture...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 21/09/2015