Publication: Valoración de la morbi-mortalidad de los pacientes ingresados por una fractura de cadera
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2017-09-15
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Universidad Complutense de Madrid
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Abstract
Las fracturas de cadera es una patología frecuente en personas de edad avanzada y su incidencia va en aumento. Se asocian con una morbilidad y mortalidad significativas y suponen una carga social y económica importante tanto para los cuidadores como para el sistema de salud. También pueden tener un impacto devastador en los pacientes y en sus familias, ya que se asocian con un aumento significativo de la morbilidad y mortalidad, añadido a que muchos pacientes no pueden volver a caminar ni volver a su residencia previa. Había 50.000 fracturas de cadera en España en 2008, y el número de las mismas es cada vez mayor. Los gastos de hospitalización de fractura de cadera se han estimado en 400 millones de euros al año en España en este periodo. Estudios previos han estimado que la mortalidad hospitalaria de un paciente con una fractura de cadera oscila entre el 1,3 % y el 16 %, esta tasa de exceso de mortalidad es más alta en el período inmediatamente posterior al momento de padecer la fractura de cadera y parece disminuir con el tiempo a partir de entonces. La mortalidad a 1 año es del 14-45 % aproximadamente en función de los estudios. Algunos de estos trabajos han analizado los posibles determinantes o predictores de mortalidad asociados a la fractura de cadera, sobre todo se han focalizado en la edad del paciente, el sexo y comorbilidades preexistentes. Hasta la fecha, sin embargo, estos factores, como variables aisladas, han sido de utilidad limitada en la práctica clínica a la hora de predecir el riesgo de mortalidad de un paciente afecto de una fractura de cadera...
Hip fractures are frequent in elderly and their incidence is rising. They are associated with significant morbidity and mortality and are a substantial burden for both caregivers and health system. They can also have a devasting impact on patient and their families, which are associated with significant morbidity and mortality, and many patients are unable to return to walk and home. There were 50.000 hip fractures in Spain in 2008, and the number of hip fractures is increasing. The costs of hospitalization of hip fracture have been estimated at 400 million euros a year in Spain in this period. Previous studies have estimated that inhospital mortality for a patient with a hip fracture is between 1.3% and 16%, This excess mortality rate is highest in the immediate period following the hip fracture event and appears to decrease with time thereafter. Whereas 1-year mortality is 14–45%. Some of these studies have looked at possible determinants or predictors of hip fracture mortality and mainly they have considered patients’ age, sex, and pre-existing or baseline comorbidities. To date, however, these factors have been of limited utility in clinical practice. Given how common and costly hip fractures are, preoperative recognition of patients at particularly high risk for adverse outcome may be useful. We can adjust mortality risk and show it in informed consent, we could determine the best time to surgery of the patient, we could adjust resources based on the chances of survival of the patients and can serve as internal audit system...
Hip fractures are frequent in elderly and their incidence is rising. They are associated with significant morbidity and mortality and are a substantial burden for both caregivers and health system. They can also have a devasting impact on patient and their families, which are associated with significant morbidity and mortality, and many patients are unable to return to walk and home. There were 50.000 hip fractures in Spain in 2008, and the number of hip fractures is increasing. The costs of hospitalization of hip fracture have been estimated at 400 million euros a year in Spain in this period. Previous studies have estimated that inhospital mortality for a patient with a hip fracture is between 1.3% and 16%, This excess mortality rate is highest in the immediate period following the hip fracture event and appears to decrease with time thereafter. Whereas 1-year mortality is 14–45%. Some of these studies have looked at possible determinants or predictors of hip fracture mortality and mainly they have considered patients’ age, sex, and pre-existing or baseline comorbidities. To date, however, these factors have been of limited utility in clinical practice. Given how common and costly hip fractures are, preoperative recognition of patients at particularly high risk for adverse outcome may be useful. We can adjust mortality risk and show it in informed consent, we could determine the best time to surgery of the patient, we could adjust resources based on the chances of survival of the patients and can serve as internal audit system...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Cirugía, leída el 22-01-2016