Comorbidities, clinical intercurrences, and factors associated with mortality in elderly patients admitted for a hip fracture

摘要

Objective To analyze comorbidities and clinical complications, and to determine the factors associated with mortality rates of elderly patients admitted with a hip fracture in a tertiary public hospital. Methods Sixty-seven medical records were reviewed in a retrospective cohort study, including patients equal to or older than 65 years admitted to this institution for hip fracture between January 2014 and December 2014. The evaluated items constituted were the following: interval of time between fracture and hospital admission, time between admission and surgical procedure, comorbidities, clinical complications, type of orthopedic procedure, surgical risk, cardiac risk, and patient outcome. Results The average patients’ age in the sample was 77.6 years, with a predominance of the female gender. Most patients (50.7%) had two or more comorbidities. The main clinical complications during hospitalization included cognitive behavioral disorders, respiratory infection and of the urinary tract. The times between fracture and admission and between admission and surgery were more than seven days in most of cases. The mortality rate during hospitalization was 11.9%, and was directly connected to the presence of infections during hospital stay ( p =0.006), to time between admission and surgery longer than seven days ( p =0.005), to the Goldman Cardiac Risk Index class III ( p =0.008), and to age equal to or greater than 85 years ( p =0.031). Conclusion Patients with hip fractures generally present comorbidities, are susceptible to clinical complications, and have an 11.9% mortality rate.