RESUMEN
OBJECTIVE: The aim of this study is to identify the risks factors for mortality and functional recovery in elderly patients admitted to hospital with a hip fracture. MATERIALS AND METHODS: Longitudinal prospective study in patients 80 years old or more and patients between 75 and 79 in residential home care with a hip fracture and with a past medical history of dementia or followed-up by the Geriatric Unit. A total of 359 patients were included, and the demographic data, previous functional status, comorbidity, type of fracture, and dementia were recorded. The data collected during admission included time to surgery, delirium, functional recovery, length of stay, placement at discharge, and mortality. Patients were followed-up for one year and details were collected on placement at the end of follow-up, functional recovery, medical complications, and mortality. RESULTS: The baseline characteristics of the patients with a strong association with mortality after a hip fracture were old age (> 92 years), medical complications delaying surgery (HR 2.17; 95% CI; 1.27-3.73), diagnosis of dementia (HR 1.78; 95% CI; 1.15-2.75), or heart failure (HR 1.75; 95% CI; 1.12-2.75). The fitted multivariable regression models showed that functional impairment before the hip fracture or lack of functional recovery are associated with higher mortality, and patients with increased age, delirium, dementia, and previous functional impairment showed worse functional recovery. CONCLUSION: In the elderly patients with a hip fracture, increased age, comorbidity and previous functional status is associated with mortality. Functional recovery prognosis will depend on age, previous functional status, past medical history of dementia, and the presence of delirium during admission.
Asunto(s)
Fracturas de Cadera/mortalidad , Fracturas de Cadera/terapia , Recuperación de la Función , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Estudios Longitudinales , Masculino , Pronóstico , Estudios Prospectivos , Factores de TiempoRESUMEN
The diagnosis of pseudoaneurysm of the deep femoral artery as a late complication after orthopaedic surgery is uncommon. The causes of the injury of the artery may be due to the intervention technique itself (mainly the orthopaedic materials or the use of clips), and less frequently by fragments displaced by the trochanter. A case of pseudoaneurysm of the deep femoral artery by a less displaced trochanter fragment is presented in this article, showing how the different professionals interacted, and with the intervention of specialists in angioradiology to resolve it.