Hip fracture in a developing country: a picture in need of change

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Data

2014

Autores

Vidal, Edison Iglesias de Oliveira [UNESP]
Moreira Filho, Djalma de Carvalho
Pinheiro, Rejane Sobrino
Souza, Romulo Cristovão
Almeida, Liz Maria de
Camargo Jr., Kenneth Rochel de
Boas, Paulo José Fortes Villas [UNESP]
Fukushima, Fernanda Bono [UNESP]
Coeli, Cláudia Medina

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Resumo

Objectives: To describe the clinical profile, patterns of care and mortality rates of aged patients who have undergone hip fracture surgical repair. Design: Retrospective patient record study. Setting: A public university hospital in Rio de Janeiro, Brazil. Participants: 352 patients aged 60 and older who underwent surgery for hip fracture between 1995-2000. Measurements: Sociodemographic data, type of fracture, cause of fracture, time from fracture to surgery, physical status, Charlson comorbidity index, type of surgery and anesthesia, access to in-hospital physiotherapy, use of antibiotic and thromboembolism prophylaxis, and mortality within one year after hospital admission. Results: Among 352 subjects, 74.4% were women. The mean age overall was 77.3 years. Very long delays from the time of fracture to hospital admission (mean 3 days) and from hospital admission to surgery (mean 13 days) were observed. Most femoral neck fractures (82.7%) were managed by hip arthroplasties, while 92.8% of the intertrochanteric fractures underwent internal fixation procedures. Less than 10% of patients received in-hospital physiotherapy. Mortality rates 30 days, 90 days and one year after hospital admission were 3.4%, 8.0% and 13.4%, respectively. Conclusion: Our study provides evidence within the context of a developing country of major gaps in the quality of care of vulnerable older adults who suffered a hip fracture. Our findings suggest that hip fracture has not been treated as an urgent condition or a priority within the Brazilian public healthcare system. Further research should address current patterns of care for hip fracture in Brazil and in other developing countries.

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Palavras-chave

Hip fractures, Osteoporosis, Quality of health care, Developing countries, Brazil

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Journal of Aging Research & Clinical Practice, v. 3, n. 3, p. 182-188, 2014.