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Wien Med Wochenschr ; 163(19-20): 435-41, 2013 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-24201598

RESUMO

In patients with hip fractures, in order to reduce the high number of general complications and those associated with the specific treatment, the functional loss and cognitive impairment, implementation of co-ordinated, multidisciplinary treatment pathways, and rehabilitation, is mandatory. The imminent treatment of proximal femoral fracture consists of major orthopaedic surgery in most cases (total or partial hip arthroplasty, osteosynthesis). After the diagnosis of a hip fracture, an adequate pain medication should be initiated. The decision making for the fracture treatment includes fracture type, patient's age, cognitive function, mobility before the fall and functional demands of the patient in the context of patients life expectancy and goals of care. The anaesthesiological evaluation focuses on risk assessment. Medical abnormalities should be optimized within 24 to 48 h, or an increased perioperative risk due to comorbidities has to be accepted. The timing and the course of further preoperative diagnostic examinations and therapeutic interventions should be co-ordinated between the involved medical disciplines. After the operation a structured screening for delirium should be initiated and further evaluation of patient's nutrition, fall-associated medication, living conditions and osteoporosis treatment has to be performed.


Assuntos
Anestesia Geral , Comportamento Cooperativo , Procedimentos Clínicos/organização & administração , Fraturas do Quadril/cirurgia , Comunicação Interdisciplinar , Fraturas por Osteoporose/cirurgia , Equipe de Assistência ao Paciente/organização & administração , Idoso , Idoso de 80 Anos ou mais , Áustria , Indicadores Básicos de Saúde , Fraturas do Quadril/mortalidade , Humanos , Fraturas por Osteoporose/mortalidade , Assistência Perioperatória , Complicações Pós-Operatórias/mortalidade , Complicações Pós-Operatórias/prevenção & controle , Taxa de Sobrevida
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