journal articles
HIP FRACTURE IN A DEVELOPING COUNTRY: A PICTURE IN NEED OF CHANGE
E.I. O. Vidal, D.C. Moreira-Filho, R.S. Pinheiro, R.C. Souza, L.M. Almeida, K.R. Camargo Jr, P.J.F. Villas Boas, F.B. Fukushima, C.M. Coeli
J Aging Res Clin Practice 2014;3(3):182-188
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.
CITATION:
E.I. O. Vidal ; D.C. Moreira-Filho ; R.S. Pinheiro ; R.C. Souza ; L.M. Almeida ; K.R. Camargo Jr ; P.J.F. Villas Boas ; F.B. Fukushima ; C.M. Coeli (2014): HIP FRACTURE IN A DEVELOPING COUNTRY: A PICTURE IN NEED OF CHANGE. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2014.32