RESUMO
OBJECTIVE: To study the implications of osteoporotic pelvic fractures in older patients in terms of mortality, length of hospital stay and independent living. METHODS: The study included 110 consecutive patients, aged over 60 years, with osteoporotic pelvic fractures admitted to the Queen Elizabeth Hospital, Gateshead, between July 2009 and March 2011. Demographic and routine clinical data were collected prospectively until date of discharge, and vital status data were collected up to 3 months post-fracture. These data were analysed to assess associations with outcomes such as length of hospital stay, mortality and loss of independence (according to changes in residential housing status). RESULTS: Fourteen patients died either in hospital, or within 3 months of fracture. Length of hospital stay was associated with age (b=0.77 days per year, 95% CI 0.001, 1.54, P=0.05) and was significantly longer in those with acute medical problems on admission (b=21.2 days, 95% CI 8.72, 33.73, P=0.001). The odds of changing from independent to institutionalised accommodation were significantly associated with age (OR 1.08 per year, 95% CI 1.01, 1.04, P=0.007) and length of hospital stay (OR 1.12 per day, 95% CI 1.01, 1.04, P=0.007). CONCLUSION: In-hospital mortality rates in this patient group are similar to those seen for hip fractures, yet pelvic fractures in older people receive relatively little in the way of attention or funding. Guidelines to improve the management of such fractures in older people are important to improve care while in hospital, reduce time spent in hospital and reduce the impact on independent living.
Assuntos
Moradias Assistidas , Mortalidade Hospitalar , Vida Independente , Tempo de Internação , Fraturas por Osteoporose , Ossos Pélvicos/lesões , Idoso , Idoso de 80 Anos ou mais , Inglaterra/epidemiologia , Feminino , Humanos , Modelos Lineares , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fraturas por Osteoporose/diagnóstico , Fraturas por Osteoporose/mortalidade , Fraturas por Osteoporose/fisiopatologia , Fraturas por Osteoporose/terapia , Ossos Pélvicos/fisiopatologia , Prognóstico , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Fatores de TempoRESUMO
We present a case report of an 86-year-old lady with pubic ramus and sacral insufficiency fractures who developed extra-vesical bladder rupture following displacement of the pubic ramus fracture, a very unusual complication.
