Epidemiologia das fraturas do ter?o proximal do fêmur em pacientes idosos

摘要

ResumoObjetivo Estudo epidemiológico das fraturas do ter?o proximal do fêmur em pacientes idosos, tratados em hospital‐escola na regi?o central de S?o Paulo. Métodos Pacientes a partir 60 anos atendidos no período de um ano. Questionário foi elaborado com informa??es sociodemográficas básicas, comorbidades apresentadas e medica??es em uso. Foram avaliadas circunstancias da fratura e suas características, tratamento instituído e taxa de mortalidade intra‐hospitalar. Resultados Os 113 pacientes incluídos no estudo apresentavam 79 anos em média. A propor??o entre os sexos foi de três mulheres para cada homem. Somente 30,4% dos pacientes relataram osteoporose e somente 0,9% tratavam a doen?a. Trauma de baixa energia foi a causa de 92,9% das fraturas. Fraturas do colo do fêmur representaram 42,5% das fraturas e trocantéricas 57,5%. Cinco pacientes n?o foram operados, 39 foram submetidos a substitui??o articular e 69 foram submetidos a osteossíntese. O tempo médio de interna??o foi de 13,5 dias e de espera até a cirurgia sete dias. A taxa de mortalidade intra‐hospitalar foi de 7,1%. Conclus?o Pacientes atendidos na institui??o apresentam perfil epidemiológico semelhante àqueles encontrados em literatura nacional. Insuficiência renal cr?nica é um fator significativo para mortalidade intra‐hospitalar. Medidas preventivas como diagnóstico precoce e tratamento da osteoporose e prática regular de atividades físicas n?o s?o adotadas. Abstract Objective This was an epidemiological study on fractures of the proximal third of the femur in elderly patients who were treated at a teaching hospital in the central region of S?o Paulo. Methods The subjects were patients over the age of 60 years who were attended over a one‐year period. A questionnaire seeking basic sociodemographic data and information on comorbidities presented and medications used was drawn up. The circumstances of the fractures and their characteristics, the treatment instituted and the intra‐hospital mortality rate were evaluated. Results The 113 patients included in the study presented a mean age of 79 years. The ratio between the sexes was three women to each man. Only 30.4% of the patients reported having osteoporosis and only 0.9% had had treatment for the disease. Low‐energy trauma was the cause of 92.9% of the fractures. Femoral neck fractures accounted for 42.5% of the fractures and trochanteric fractures, 57.5%. Five patients did not undergo operations; 39 underwent joint replacement; and 69 underwent osteosynthesis. The mean length of hospital stay was 13.5 days and the mean length of waiting time until surgery was seven days. The intra‐hospital mortality rate was 7.1%. Conclusion The patients attended at this institution presented an epidemiological profile similar to what is found in the Brazilian literature. Chronic kidney failure is a significant factor with regard to intra‐hospital mortality. Preventive measures such as early diagnosis and treatment of osteoporosis and regular physical activity practices were not implemented.