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Abstract(s)
Introdução: A osteoporose (OP) é uma doença caracterizada por diminuição da massa óssea e deterioração da microarquitectura do osso, conduzindo a um aumento do risco de fratura. Trata-se de uma doença com uma elevada prevalência, que aumenta com a idade, particularmente nas mulheres após a menopausa. De entre as complicações mais frequentes e graves da OP destacam-se as fraturas da extremidade proximal do fémur (FEPF), que estão associadas a altas taxas de mortalidade e dependência de terceiros. Tendo a Unidade Local de Saúde (ULS) de Castelo Branco, EPE, uma área de influência em que os idosos representam uma importante parcela da população, é imperativo a condução de estudos elucidativos sobre o real espectro desta patologia na população.
Materiais e métodos: Estudo observacional, retrospetivo, longitudinal e analítico das mulheres com idade igual ou superior a 65 anos, internadas no Serviço de Ortopedia do Hospital Amato Lusitano (HAL), entre janeiro 2012 e dezembro 2013, devido a FEPF de baixo impacto. A recolha de dados foi feita através da consulta de processos clínicos. A análise estatística foi efetuada através do teste t-student e consideraram-se os resultados significativos para p <0,05.
Resultados: Calculou-se uma incidência anual de FEPF, em mulheres com idade igual ou superior a 65 anos, de 775,5 por 100.000 habitantes. A idade média das pacientes foi de 84,75 ± 6,52 anos. A hipertensão arterial foi a doença mais observada (64,1%). 25,3% das pacientes apresentaram antecedentes de fratura de baixo impacto, sendo que a fratura mais frequente foi a FEPF (9,5%). Em apenas 6,6% dos processos das pacientes constava o registo de diagnóstico de OP. De igual modo, apenas 7,6% e 14,8% das pacientes se encontravam medicadas com tratamento anti-osteoporótico prévia e posteriormente à fratura, respetivamente. O tempo de espera cirúrgico foi em média de 1,91 ± 2,85 dias. Em relação ao tratamento prestado, apenas em 3,9% das pacientes se optou pelo tratamento conservador. Um ano após fratura, a taxa de mortalidade foi de 18,8%. Os fatores de risco associados à mortalidade após FEPF foram a idade, classificação ASA e tratamento conservador.
Conclusão: Ficou demostrada a importância acrescida da OP e da FEPF em populações onde a faixa etária constituída por pessoas acima dos 65 anos representa uma parcela importante. Examinando os parâmetros estudados, verifica-se uma resposta pronta após FEPF, no entanto, muito pouco está a ser feito ao nível da prevenção, diagnóstico e tratamento da OP.
Introduction: Osteoporosis (OP) is a disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to increased risk of fracture. It is a high prevalence disease, particularly in post-menopausal women. Hip fractures stand out from among the most frequent and serious complications of OP, which are associated with high mortality rates and dependence. Having the Unidade Local de Saúde (ULS) de Castelo Branco, EPE, an intervention area in which elderly people represent a significant part of the population, conducting further studies is imperative to comprehend the real spectrum of this disease. Methods: Observational, retrospective, longitudinal and analytical study of women over 65 years, admitted to the Serviço de Ortopedia do Hospital Amato Lusitano (HAL), between January 2012 and December 2013, due to hip fracture. Data was collected through clinical process consultation. Statistical analysis was performed using the t-student test and were considered significant for p < 0.05. Results: It was calculated an annual incidence of hip fracture in women aged over 65 years of 775,5 per 100.000 inhabitants. The average age of patients was 84,75 ± 6,52 years. Hypertension was the most observed disease (64,1%). 25,3% of patients had low impact fracture history, and the most common was hip fracture (9,5%). Only 6,6% of patients had a record of OP diagnosis in their clinical process. Likewise, only 7,6% and 14,8% of the patients were medicated with anti-osteoporosis treatment prior to, as well as after, the fracture. Surgical delay averaged 1,91 ± 2,85 days. In relation to the treatment provided, conservative treatment was applied only in 3,9% of the patients. One year after the fracture, mortality rate was 18,8%. Risk factors associated with hip fracture mortality were age, ASA classification and conservative treatment. Conclusion: It was proven the increased importance of the OP and hip fracture in populations where elderly people are a relevant part. By examining the parameters studied, it is possible to verify that an immediate response after hip fracture exists, however very little is being done in terms of prevention, diagnosis and treatment of OP.
Introduction: Osteoporosis (OP) is a disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to increased risk of fracture. It is a high prevalence disease, particularly in post-menopausal women. Hip fractures stand out from among the most frequent and serious complications of OP, which are associated with high mortality rates and dependence. Having the Unidade Local de Saúde (ULS) de Castelo Branco, EPE, an intervention area in which elderly people represent a significant part of the population, conducting further studies is imperative to comprehend the real spectrum of this disease. Methods: Observational, retrospective, longitudinal and analytical study of women over 65 years, admitted to the Serviço de Ortopedia do Hospital Amato Lusitano (HAL), between January 2012 and December 2013, due to hip fracture. Data was collected through clinical process consultation. Statistical analysis was performed using the t-student test and were considered significant for p < 0.05. Results: It was calculated an annual incidence of hip fracture in women aged over 65 years of 775,5 per 100.000 inhabitants. The average age of patients was 84,75 ± 6,52 years. Hypertension was the most observed disease (64,1%). 25,3% of patients had low impact fracture history, and the most common was hip fracture (9,5%). Only 6,6% of patients had a record of OP diagnosis in their clinical process. Likewise, only 7,6% and 14,8% of the patients were medicated with anti-osteoporosis treatment prior to, as well as after, the fracture. Surgical delay averaged 1,91 ± 2,85 days. In relation to the treatment provided, conservative treatment was applied only in 3,9% of the patients. One year after the fracture, mortality rate was 18,8%. Risk factors associated with hip fracture mortality were age, ASA classification and conservative treatment. Conclusion: It was proven the increased importance of the OP and hip fracture in populations where elderly people are a relevant part. By examining the parameters studied, it is possible to verify that an immediate response after hip fracture exists, however very little is being done in terms of prevention, diagnosis and treatment of OP.
Description
Keywords
Fratura da Extremidade Proximal do Fémur Mortalidade Mulheres Pós-Menopáusicas Osteoporose Prevenção