Development and Validation of the 17-Point Brazilian Portuguese Translated Version of the Modified Japanese Orthopedic Association Score (mJOA-BR17).

BACKGROUND: Cervical spondylotic myelopathy (CSM) is the most common degenerative dysfunction of the spinal cord in the cervical spine in patients older than 55 years. The Japanese Orthopedic Association developed a scoring system to quantify clinical impairment of CSM patients, allocate them according to the degree of impairment, and suggest best timing for surgery. The original version evaluates the upper limb motor function through the ability of feeding with chopsticks, which are not intrinsic in western populations. To compare severity and treatment improvement of any diseases, it is preferable to have modified and translated versions of questionnaires and scores closest to the original ones. The authors present a prospective cohort study to validate the 17-point Brazilian Portuguese translated version of the modified Japanese Orthopedic Association (mJOA-BR17) survey. METHODS: Patients with CSM (n = 36) were allocated to the disease group, while age- and sex-matched healthy volunteers (n = 34) were recruited for the control group. Comparison of statistical analysis of mJOA-BR17 domains for each group was established. After the translation and adaptation of mJOA-BR17, the validation was made through application to the 2 groups. RESULTS: There were statistical differences between groups in total mJOA-BR17 score (CSM, 14.14 ± 2.92; control, 16.68 ± 0.59: P < 0.001), lower limbs motor function (CSM, 3.25 ± 1.02; control, 3.91 ± 0.29: P < 0.001), upper limbs sensory function (CSM, 1.17 ± 0.81; control, 1.86 ± 0.36: P < 0.001), lower limbs sensory function (CSM, 1.62 ± 0.64; control, 2.0 ± 0.0: P < 0.001), and bladder function (CSM, 2.69 ± 0.52; control, 2.97 ± 0.17: P = 0.005). The receiver operating characteristic curve was 0.81, indicating usefulness of the mJOA-BR17 score to identify patients with CSM from healthy controls. CONCLUSIONS: The mJOA-BR17 demonstrated similarity, applicability, and good understanding in comparison to the English-modified version of 17-point JOA score for CSM, becoming a valuable tool to quantify and differentiate CSM patients from healthy individuals.

EPIDEMIOLOGY OF PROXIMAL FEMUR FRACTURE IN OLDER ADULTS IN A PHILANTHROPICAL HOSPITAL IN SÃO PAULO.

Objective: To evaluate the age and anthropometry profile of patients with a diagnosis of fracture of the proximal femur in older adults admitted to a philanthropic hospital in São Paulo. Methods: Retrospective observational cross-sectional study. All patients older than 59 years with femoral fractures diagnosed and hospitalized between January, 2019 and April, 2020 were included. The analysis of the 85 medical records resulted in the data collected in the present study. Anthropometry, age, sex, ethnicity, presence of comorbidities and mechanism of trauma of these patients were considered in this study. Most traumas, as expect, presented low energy mechanisms. Results: Prevalence of 3:1 in females, aged between 60-104 and mean of 78.5 years, with an increased risk in patients over 80 years. The body mass index (BMI) between 16.53 and 39.80 with an average of 24.16 kg/m2. Being 89.4% cases of fall from own height. Conclusion: Proximal femur fractures in older adults occur more often in women, with a mean age of 78.5 years, normal BMI range, whose main trauma mechanism is fall to ground level. The most prevalent injury is transtrochanteric fracture, with a mean of 70.5% and the most performed treatment is internal fixation with cephalomedullary nail, with a mean of 66.1%. Level of Evidence VI, Descriptive Epidemiological Study.

Objetivo: Avaliar o perfil de idade e antropometria dos pacientes com diagnóstico de fratura do fêmur proximal em idosos admitidos em um hospital filantrópico de São Paulo. Métodos: Estudo retrospectivo, observacional, transversal. Foram incluídos todos os pacientes com fratura do fêmur proximal e idade superior a 59 anos, internados em um hospital filantrópico de São Paulo entre janeiro de 2019 e abril de 2020. A análise dos 85 prontuários levantados resultou na coleta de dados antropométricos, idade, sexo e etnia, doenças associadas e uso de medicações, além de dados relacionados ao mecanismo de trauma. Como esperado, a maioria dos traumas apresentou mecanismo de baixa energia. Resultados: Houve predominância de 3:1 do sexo feminino, com idade entre 60 e 104 e média de 78,5 anos, havendo um risco maior para pacientes acima dos 80 anos. O índice de massa corpórea (IMC) foi de 16,53 a 39,80, com média de 24,16 kg/m2. Quanto ao mecanismo do trauma, 89,4% dos casos foram de queda da própria altura. Conclusão: Fraturas do fêmur proximal em idosos ocorrem mais em mulheres, com idade média de 78,5 anos, IMC na faixa normal e queda ao nível do solo como principal mecanismo de trauma. A lesão mais prevalente foi a fratura transtrocanteriana, com média de 70,5%, e o tratamento mais realizado foi a fixação interna com haste cefalomedular (66,1%). Nível de Evidência VI, Estudo Epidemiológico Descritivo.

Epidemiology of proximal femur fracture in older adults in a philanthropical hospital in são paulo / Epidemiologia da fratura do fêmur proximal em idosos em um hospital filantrópico de são paulo

ABSTRACT Objective: To evaluate the age and anthropometry profile of patients with a diagnosis of fracture of the proximal femur in older adults admitted to a philanthropic hospital in São Paulo. Methods: Retrospective observational cross-sectional study. All patients older than 59 years with femoral fractures diagnosed and hospitalized between January, 2019 and April, 2020 were included. The analysis of the 85 medical records resulted in the data collected in the present study. Anthropometry, age, sex, ethnicity, presence of comorbidities and mechanism of trauma of these patients were considered in this study. Most traumas, as expect, presented low energy mechanisms. Results: Prevalence of 3:1 in females, aged between 60-104 and mean of 78.5 years, with an increased risk in patients over 80 years. The body mass index (BMI) between 16.53 and 39.80 with an average of 24.16 kg/m2. Being 89.4% cases of fall from own height. Conclusion: Proximal femur fractures in older adults occur more often in women, with a mean age of 78.5 years, normal BMI range, whose main trauma mechanism is fall to ground level. The most prevalent injury is transtrochanteric fracture, with a mean of 70.5% and the most performed treatment is internal fixation with cephalomedullary nail, with a mean of 66.1%. Level of Evidence VI, Descriptive Epidemiological Study.

RESUMO Objetivo: Avaliar o perfil de idade e antropometria dos pacientes com diagnóstico de fratura do fêmur proximal em idosos admitidos em um hospital filantrópico de São Paulo. Métodos: Estudo retrospectivo, observacional, transversal. Foram incluídos todos os pacientes com fratura do fêmur proximal e idade superior a 59 anos, internados em um hospital filantrópico de São Paulo entre janeiro de 2019 e abril de 2020. A análise dos 85 prontuários levantados resultou na coleta de dados antropométricos, idade, sexo e etnia, doenças associadas e uso de medicações, além de dados relacionados ao mecanismo de trauma. Como esperado, a maioria dos traumas apresentou mecanismo de baixa energia. Resultados: Houve predominância de 3:1 do sexo feminino, com idade entre 60 e 104 e média de 78,5 anos, havendo um risco maior para pacientes acima dos 80 anos. O índice de massa corpórea (IMC) foi de 16,53 a 39,80, com média de 24,16 kg/m2. Quanto ao mecanismo do trauma, 89,4% dos casos foram de queda da própria altura. Conclusão: Fraturas do fêmur proximal em idosos ocorrem mais em mulheres, com idade média de 78,5 anos, IMC na faixa normal e queda ao nível do solo como principal mecanismo de trauma. A lesão mais prevalente foi a fratura transtrocanteriana, com média de 70,5%, e o tratamento mais realizado foi a fixação interna com haste cefalomedular (66,1%). Nível de Evidência VI, Estudo Epidemiológico Descritivo.