Feb 19

Causa de muerte y los factores asociados con la mortalidad temprana en el hospital después de una fractura de cadera / Cause of death and factors associated with early in-hospital mortality after hip fracture

Este artículo es originalmente publicado en:
Chatterton BD1, Moores TS1, Ahmad S1, Cattell A1, Roberts PJ1.
Bone Joint J. 2015 Feb;97-B(2):246-51. doi: 10.1302/0301-620X.97B2.35248.
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The aims of this study were to identify the early in-hospital mortality rate after hip fracture, identify factors associated with this mortality, and identify the cause of death in these patients. A retrospective cohort study was performed on 4426 patients admitted to our institution between the 1 January 2006 and 31 December 2013 with a hip fracture (1128 male (26%), mean age 82.0 years (60 to 105)). Admissions increased annually, but despite this 30-day mortality decreased from 12.1% to 6.5%; 77% of these were in-hospital deaths. Male gender (odds ratio (OR) 2.0, 95% confidence interval (CI) 1.3 to 3.0), increasing age (age ≥ 91; OR 4.1, 95% CI 1.4 to 12.2) and comorbidity (American Society of Anesthesiologists grades 3 to 5; OR 4.2, 95% CI 2.0 to 8.7) were independently and significantly associated with increased odds of in-hospital mortality. From 220 post-mortem reports, the most common causes of death were respiratory infections (35%), ischaemic heart disease (21%), and cardiac failure (13%). A sub-group of hip fracture patients at highest risk of early death can be identified with these risk factors, and the knowledge of the causes of death can be used to inform service improvements and the development of a more didactic care pathway, so that multidisciplinary intervention can be focused for this sub-group in order to improve their outcome. Cite this article: Bone Joint J 2015;97-B:246-51.
©2015 The British Editorial Society of Bone & Joint Surgery.
Los objetivos de este estudio fueron identificar la tasa de mortalidad precoz en el hospital después de la fractura de cadera, identificar los factores asociados a esta mortalidad, y determinar la causa de muerte en estos pacientes. Un estudio de cohorte retrospectivo se realizó en 4.426 pacientes ingresados ​​en nuestra institución entre el 1 de enero 2006 y 31 de diciembre de 2013, con una fractura de cadera (1.128 varones (26%), edad media 82,0 años (60 a 105)). Admisiones incrementados anualmente, pero a pesar de ello la mortalidad a 30 días disminuyó de 12,1% a 6,5%; 77% de ellos eran muertes intrahospitalarias. El sexo masculino (odds ratio (OR) 2,0; intervalo de confianza del 95% (IC) 1,3-3,0), aumento de la edad (edad ≥ 91; IC OR 4.1, 95%: 1,4 a 12.2) y la comorbilidad (Sociedad Americana de Anestesiólogos grados 3-5 ; O 4,2, IC 95% 2,0-8,7) se asociaron de forma independiente y significativa con el aumento de las probabilidades de mortalidad hospitalaria. De 220 informes post mortem, las causas más comunes de muerte fueron las infecciones respiratorias (35%), la cardiopatía isquémica (21%) e insuficiencia cardiaca (13%). Un subgrupo de pacientes con fractura de cadera en mayor riesgo de muerte prematura puede identificarse con estos factores de riesgo, y el conocimiento de las causas de la muerte puede ser utilizada para informarle de las mejoras de servicios y el desarrollo de una vía de atención más didáctica, para que multidisciplinario la intervención se puede enfocar para este sub-grupo con el fin de mejorar sus resultados.


Hip fracture; mortality; cause of death




[PubMed – in process]

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