Early interdisciplinary hospital intervention for elderly patients with hip fractures : functional outcome and mortality
Autor(a) principal: | |
---|---|
Data de Publicação: | 2012 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Clinics |
Texto Completo: | https://www.revistas.usp.br/clinics/article/view/40006 |
Resumo: | OBJECTIVES: Hip fractures are associated with high levels of co-morbidity and mortality. Orthogeriatric units have been shown to be effective with respect to functional recovery and mortality reduction. The aim of this study is to document the natural history of early multidisciplinary intervention in elderly patients with hip fractures and to establish the prognostic factors of mortality and walking ability after discharge. METHODS: This observational, retrospective study was performed in an orthogeriatric care unit on patients aged >;70 years with a diagnosis of hip fracture between 2004 and 2008. This study included 1363 patients with a mean age of 82.7 + 6.4 years. RESULTS: On admission to the unit, the average Barthel score of these patients was 77.2 + 27.8 points, and the average Charlson index score was 2.14 + 2.05. The mean length of stay was 8.9 + 4.26 days, and the readmission rate was 2.3%. The in-hospital mortality rate was 4.7%, and the mortality rates at one, six, and 12 months after discharge were 8.7%, 16.9%, and 25.9%, respectively. The Cox proportional hazards model estimated that male sex, Barthel scale, heart failure, and cognitive impairment were associated with an increased risk of death. With regard to functionality, 63.7% of the patients were able to walk at the time of discharge, whereas 77.4% and 80.1% were able to walk at one month and six months post-discharge, respectively. The factors associated with a worse functional recovery included cognitive impairment, performance status, age, stroke, Charlson score, and delirium during the hospital stay. CONCLUSIONS: Early multidisciplinary intervention appears to be effective for the management of hip fracture. Age, male sex, baseline function, cognitive impairment and previous comorbidities are associated with a higher mortality rate and worse functional recovery. |
id |
USP-19_56bac1e110721b03e4e9df3a9d11d33f |
---|---|
oai_identifier_str |
oai:revistas.usp.br:article/40006 |
network_acronym_str |
USP-19 |
network_name_str |
Clinics |
repository_id_str |
|
spelling |
Early interdisciplinary hospital intervention for elderly patients with hip fractures : functional outcome and mortalityHip FracturesRisk FactorsGeriatric InterventionMortalityWalkingOBJECTIVES: Hip fractures are associated with high levels of co-morbidity and mortality. Orthogeriatric units have been shown to be effective with respect to functional recovery and mortality reduction. The aim of this study is to document the natural history of early multidisciplinary intervention in elderly patients with hip fractures and to establish the prognostic factors of mortality and walking ability after discharge. METHODS: This observational, retrospective study was performed in an orthogeriatric care unit on patients aged >;70 years with a diagnosis of hip fracture between 2004 and 2008. This study included 1363 patients with a mean age of 82.7 + 6.4 years. RESULTS: On admission to the unit, the average Barthel score of these patients was 77.2 + 27.8 points, and the average Charlson index score was 2.14 + 2.05. The mean length of stay was 8.9 + 4.26 days, and the readmission rate was 2.3%. The in-hospital mortality rate was 4.7%, and the mortality rates at one, six, and 12 months after discharge were 8.7%, 16.9%, and 25.9%, respectively. The Cox proportional hazards model estimated that male sex, Barthel scale, heart failure, and cognitive impairment were associated with an increased risk of death. With regard to functionality, 63.7% of the patients were able to walk at the time of discharge, whereas 77.4% and 80.1% were able to walk at one month and six months post-discharge, respectively. The factors associated with a worse functional recovery included cognitive impairment, performance status, age, stroke, Charlson score, and delirium during the hospital stay. CONCLUSIONS: Early multidisciplinary intervention appears to be effective for the management of hip fracture. Age, male sex, baseline function, cognitive impairment and previous comorbidities are associated with a higher mortality rate and worse functional recovery.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2012-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/4000610.6061/clinics/2012(06)02Clinics; Vol. 67 No. 6 (2012); 547-556Clinics; v. 67 n. 6 (2012); 547-556Clinics; Vol. 67 Núm. 6 (2012); 547-5561980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/40006/42871Tarazona-Santabalbina, Francisco JoséBelenguer-Varea, ÁngelRovira-Daudi, EduardoSalcedo-Mahiques, EnmanuelCuesta-Peredó, DavidDoménech-Pascual, Juan RamónSalvador-Pérez, María IsabelAvellana-Zaragoza, Juan Antonioinfo:eu-repo/semantics/openAccess2012-08-23T17:59:54Zoai:revistas.usp.br:article/40006Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2012-08-23T17:59:54Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Early interdisciplinary hospital intervention for elderly patients with hip fractures : functional outcome and mortality |
title |
Early interdisciplinary hospital intervention for elderly patients with hip fractures : functional outcome and mortality |
spellingShingle |
Early interdisciplinary hospital intervention for elderly patients with hip fractures : functional outcome and mortality Tarazona-Santabalbina, Francisco José Hip Fractures Risk Factors Geriatric Intervention Mortality Walking |
title_short |
Early interdisciplinary hospital intervention for elderly patients with hip fractures : functional outcome and mortality |
title_full |
Early interdisciplinary hospital intervention for elderly patients with hip fractures : functional outcome and mortality |
title_fullStr |
Early interdisciplinary hospital intervention for elderly patients with hip fractures : functional outcome and mortality |
title_full_unstemmed |
Early interdisciplinary hospital intervention for elderly patients with hip fractures : functional outcome and mortality |
title_sort |
Early interdisciplinary hospital intervention for elderly patients with hip fractures : functional outcome and mortality |
author |
Tarazona-Santabalbina, Francisco José |
author_facet |
Tarazona-Santabalbina, Francisco José Belenguer-Varea, Ángel Rovira-Daudi, Eduardo Salcedo-Mahiques, Enmanuel Cuesta-Peredó, David Doménech-Pascual, Juan Ramón Salvador-Pérez, María Isabel Avellana-Zaragoza, Juan Antonio |
author_role |
author |
author2 |
Belenguer-Varea, Ángel Rovira-Daudi, Eduardo Salcedo-Mahiques, Enmanuel Cuesta-Peredó, David Doménech-Pascual, Juan Ramón Salvador-Pérez, María Isabel Avellana-Zaragoza, Juan Antonio |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Tarazona-Santabalbina, Francisco José Belenguer-Varea, Ángel Rovira-Daudi, Eduardo Salcedo-Mahiques, Enmanuel Cuesta-Peredó, David Doménech-Pascual, Juan Ramón Salvador-Pérez, María Isabel Avellana-Zaragoza, Juan Antonio |
dc.subject.por.fl_str_mv |
Hip Fractures Risk Factors Geriatric Intervention Mortality Walking |
topic |
Hip Fractures Risk Factors Geriatric Intervention Mortality Walking |
description |
OBJECTIVES: Hip fractures are associated with high levels of co-morbidity and mortality. Orthogeriatric units have been shown to be effective with respect to functional recovery and mortality reduction. The aim of this study is to document the natural history of early multidisciplinary intervention in elderly patients with hip fractures and to establish the prognostic factors of mortality and walking ability after discharge. METHODS: This observational, retrospective study was performed in an orthogeriatric care unit on patients aged >;70 years with a diagnosis of hip fracture between 2004 and 2008. This study included 1363 patients with a mean age of 82.7 + 6.4 years. RESULTS: On admission to the unit, the average Barthel score of these patients was 77.2 + 27.8 points, and the average Charlson index score was 2.14 + 2.05. The mean length of stay was 8.9 + 4.26 days, and the readmission rate was 2.3%. The in-hospital mortality rate was 4.7%, and the mortality rates at one, six, and 12 months after discharge were 8.7%, 16.9%, and 25.9%, respectively. The Cox proportional hazards model estimated that male sex, Barthel scale, heart failure, and cognitive impairment were associated with an increased risk of death. With regard to functionality, 63.7% of the patients were able to walk at the time of discharge, whereas 77.4% and 80.1% were able to walk at one month and six months post-discharge, respectively. The factors associated with a worse functional recovery included cognitive impairment, performance status, age, stroke, Charlson score, and delirium during the hospital stay. CONCLUSIONS: Early multidisciplinary intervention appears to be effective for the management of hip fracture. Age, male sex, baseline function, cognitive impairment and previous comorbidities are associated with a higher mortality rate and worse functional recovery. |
publishDate |
2012 |
dc.date.none.fl_str_mv |
2012-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/40006 10.6061/clinics/2012(06)02 |
url |
https://www.revistas.usp.br/clinics/article/view/40006 |
identifier_str_mv |
10.6061/clinics/2012(06)02 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/40006/42871 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; Vol. 67 No. 6 (2012); 547-556 Clinics; v. 67 n. 6 (2012); 547-556 Clinics; Vol. 67 Núm. 6 (2012); 547-556 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1800222758644219904 |