Proceso de recuperación en las personas mayores intervenidas por fractura de cadera

  1. María Plaza Carmona
  2. Jiménez Mola, Sonia
  3. Seco Calvo, Jesús
Journal:
Metas de enfermería

ISSN: 1138-7262

Year of publication: 2016

Volume: 19

Issue: 7

Type: Article

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Abstract

Objective: to identify the main clinical, functional and cognitive characteristics of elderly patients admitted at the Hospital Universitario de León with hip fracture, and to analyze the influence on the recovery process of their type of living environment after discharge from hospital. Methods: a preliminary transversal descriptive study that analyzed the physiological characteristics of elderly patients who were hospitalized due to hip fracture diagnosis in the Hospital de León. To this aim, >75-year-old patients were selected, who had been hospitalized due to hip fracture. The health status of patients was assessed at admission and six weeks after hospital discharge. Results: thirty-eight (38) elderly persons were included. All patients who underwent surgery experienced a significant loss of functionality regarding their basal situation (own home p< 0.009; the home of relatives p< 0.024; geriatric institution p< 0.018). The number of comorbidities presented by patients was 3.7, and this was an additional problem that complicated further the recovery process. The patients with a worse walking ability six weeks after hospital discharge were those transferred to a geriatric institution, with a significant difference in comparison with those transferred to the home of a relative (p< 0.023). Conclusions: those patients transferred to a geriatric institution after hip fracture surgery presented worse walking abilities at six weeks after hospital discharge.

Bibliographic References

  • Instituto Nacional de Estadística (INE). Encuesta personas mayores 2010.
  • United Nations. World Population Prospects: The 2006 Revision. 2008.
  • Ferrer-Arrendo C, Orozco D, Román P. Estrategia para el abordaje de la cronicidad en el Sistema Nacional de Salud. Ministerio de Sanidad y Política Social. 2012.
  • Consejería de Sanidad-Gerencia Regional de Salud de Castilla y León. Estrategia de Atención al Paciente Crónico en Castilla y León. Junta de Castilla y León 2013.
  • Ministerio de Sanidad y Política Social. Instituto de Información Sanitaria. Estadísticas comentadas: la atención a la fractura de cadera en los hospitales del SNS. Madrid 2010 [citado 20 julio 2016]. Disponible en: http://www.msssi.gob.es/estadEstudios/estadisticas/cmbdhome.htm
  • Bischoff-Ferrari HA, Orav JE, Kanis JA, Rizzoli R, Schlögl M, Staehelin HB, et al. Comparative performance of current definitions of sarcopenia against the prospective incidence of falls among community-dwelling seniors age 65 and older. Osteoporosis Int. 2015; 1-10.
  • Gómez-Cabello A, Pedrero-Chamizo R, Olivares PR, Luzardo L, Juez-Bengoechea A, Mata E, et al. Prevalence of overweight and obesity in non-institutionalized people aged 65 or over from Spain: the elderly EXERNET multi-centre study. Obes Rev. 2011; 12(8):583-92.
  • Gómez-Cabello A, Vicente RG, Vila-Maldonado S, Casajus JA, Ara I. Aging and body composition: the sarcopenic obesity in Spain. Nutr Hosp. 2012; 27(1):22-30.
  • Manthripragada AD, O’Malley CD, Gruntmanis U, Hall JW, Wagman RB, Miller PD. Fracture incidence in a large cohort of men age 30 years and older with osteoporosis. Osteoporosis Int. 2015; 26(5):1619-27.
  • Cruz-Jentoft AJ, Cuesta Triana FC, Gómez-Cabrera MC, López-Soto A, Masanés F, Martín PM, et al. La eclosión de la sarcopenia: Informe preliminar del Observatorio de la Sarcopenia de la Sociedad Española de Geriatría y Gerontología. Rev Esp Geriatr Gerontol. 2011; 46(2): 100-10.
  • Ireland AW, Kelly PJ, Cumming RG. Total hospital stay for hip fracture: measuring the variations due to pre-fracture residence, rehabilitation, complications and comorbidities. Bmc Health Serv Res. 2015; 15(1):17.
  • Johnson DJ, Greenberg SE, Sathiyakumar V, Thakore R, Ehrenfeld JM, Obremskey WT, et al. Relationship between the Charlson Comorbidity Index and cost of treating hip fractures: implications for bundled payment. J Orthop Traumatol. 2015; 1-5.
  • Nikkel LE, Fox EJ, Black KP, Davis C, Andersen L, Hollenbeak CS. Impact of comorbidities on hospitalization costs following hip fracture. The Journal of Bone & Joint Surgery. 2012; 94(1):9-17.
  • Tarazona-Santabalbina FJ, Belenguer-Varea Á, Rovira-Daudi E, Salcedo-Mahiques E, Cuesta Peredó D, Doménech-Pascual JR, et al. Severity of cognitive impairment as a prognostic factor for mortality and functional recovery of geriatric patients with hip fracture. Geriatr Gerontol Int. 2015.
  • Gullberg B, Johnell O, Kanis JA. World-wide projections for hip fracture. Osteoporosis Int. 1997; 7(5):407-13.
  • Ambrose AF, Paul G, Hausdorff JM. Risk factors for falls among older adults: a review of the literature. Maturitas. 2013; 75(1):51-61.
  • Vellas B. Aspects geriatriques de les fractures des sujets de plus de 80 ans. Revue Chirurgie Orthopedique. 2003; 89:142.
  • Cameron ID, Mrch LM. Health and medical research council. Evidence-based guidelines for the management of hip fracture in older persons. AN UPDATE. Med J Australia. 2010; 192(1):37-41.
  • González-Montalvo JI, Gotor-Pérez P, Martín-Vega A, Alarcón T, Mauleón Álvarez de Linera JL, Gil-Garay E, et al. La unidad de ortogeriatría de agudos. Evaluación de su efecto en el curso clínico de los pacientes con fractura de cadera y estimación de su impacto económico. Rev Esp Geriatr Gerontol. 2011; 46(4):193-9.
  • Abizanda S. Medicina geriátrica. Una aproximación basada en problemas. Barcelona: Masson; 2012.
  • Sáez López P, Martín Perez E, González Ramírez A, Pablos Hernández C, Jiménez Mola S, Vuelta Calzada E, et al. Actividad ortogeriátrica en los hospitales públicos de Castilla y León: descripción y revisión de la literatura. Rev Esp Geriatr Gerontol. 2014; 49(3):137-44.
  • Alarcón T, González-Montalvo JI, Mauleon JL, Menéndez-Colino R. Demora del tratamiento quirúrgico de la fractura de cadera: un suma y sigue de problemas. Rev Esp Salud Pública. 2015; 89(1):117-8.
  • Chudyk AM, Jutai JW, Petrella RJ, Speechley M. Systematic review of hip fracture rehabilitation practices in the elderly. Arch Phys Med Rehab. 2009; 90(2):246-62.
  • Patorno E, Neuman MD, Schneeweiss S, Mogun H, Bateman BT. Comparative safety of anesthetic type for hip fracture surgery in adults: retrospective cohort study. BMJ. 2014; 348:g4022.
  • Whiting PS, Molina CS, Greenberg SE, Thakore RV, Obremskey WT, Sethi MK. Regional anaesthesia for hip fracture surgery is associated with significantly more peri-operative complications compared with general anaesthesia. Int Orthop. 2015; 1-7.
  • Hung WW, Egol KA, Zuckerman JD, Siu AL. Hip fracture management: tailoring care for the older patient. JAMA. 2012; 307(20):2185-94.
  • Finsterwald M, Sidelnikov E, Orav EJ, Dawson-Hughes B, Theiler R, Egli A, et al. Gender-specific hip fracture risk in community-dwelling and institutionalized seniors age 65 years and older. Osteoporosis Int. 2014; 25(1):167-76.
  • Avellana Zaragoza J. Anciano afecto de fractura de cadera. En: Avellana Zaragoza J, Ferrández Portal LC (eds.). Sociedad Española de Geriatría y Gerontología. Guía de buena práctica clínica en Geriatría: Anciano afecto de fractura de cadera. Madrid: Elsevier; 2007. p. 105-36.
  • Jiménez Sánchez MD, Córcoles Jiménez MP, del Egido Fernández MA, Villada Munera A, Candel Parra E, Moreno Moreno M. Análisis de las caídas que producen fractura de cadera en ancianos. Enferm Clin. 2011; 21(3):143-50.
  • Smith TO, Hameed YA, Cross JL, Henderson C, Sahota O, Fox C. Enhanced rehabilitation and care models for adults with dementia following hip fracture surgery. The Cochrane Library. 2015.
  • Abizanda P, Paterna G, Martínez E, López-Jiménez E. Comorbidity in the elderly: utility and validity of assessment tools. Rev Esp Geriatr Gerontol. 2009; 45(4):219-28.
  • Reguant F, Martínez E, Gil B, Prieto JC, del Milagro Jiménez L, Arnau A, et al. Fractura de cadera, antiagregantes plaquetarios y complicaciones postoperatorias. Rev Esp Anestesiol Reanim. 2013; 60(9):504-10.
  • Klenk J, Rapp K, Denkinger MD, Nagel G, Nikolaus T, Peter R, et al. Seasonality of vitamin D status in older people in Southern Germany: implications for assessment. Age Ageing. 2013; 42(3):404-8.
  • Murad M, Elamin KB, Abu Elnour NO, Elamin MB, Alkatib AA, Fatourechi MM, et al. The effect of vitamin D on falls: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2011; 96(10):2997-3006.
  • Holvik K, Ahmed LA, Forsmo S, Gjesdal CG, Grimnes G, Samuelsen SO, et al. Low serum levels of 25-hydroxyvitamin D predict hip fracture in the elderly: a NOREPOS study. J Clin Endocrinol Metab. 2013; 98(8):3341-50.
  • Lips P. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev. 2001; 22(4):477-501.
Data source: Dialnet