Consecuencias en salud (mortalidad e institucionalización) de la fractura de cadera en la población anciana. Estudio de cohortes poblacional en Segovia

Abstract

ObjectiveIn order to know the social and health consequences of hip fractures (HF). DesignA retrospective cohort study of an entire health area was carried out in patients aged 75 or more, over a period of 5 years. SiteSegovia Health Area. ParticipantsAll patients older than 75 years with a diagnosis of HF, excluding displaced and passerby. InterventionsThe socio-sanitary changes that occur after the HF in respect to their baseline situation (family situation, comorbidities, dependence and mental situation) and the variables which most influence mortality and institutionalization after the HF were analyzed. Main measurementsOne thousand one hundred fifty-nine HF were recorded, with a constant annual incidence of 10.7‰. The prevalence was higher in women: 7.4% versus 3.7%. ResultsThe baseline profile is a pluripatological, non-institutionalized, 87-year-old woman, who retains her independent in her daily life and suffers from a HF due to an accidental fall in her home. At the end of the study period 51% were permanently institutionalized, negatively influencing having worse mental deterioration, worse dependence and subsequent readmissions and in addition, 45.5% died, 25.5% during the first year. The most unfavorable conditions were being previously dependent, having severe mental deterioration, male and within the comorbidities the most influential was previously having an anemia. ConclusionsOur data confirms the deterioration of the autonomy-functional capacity after a HF, in line with what has been published, and has allowed to identify which elderly people are at the greatest risk of complications in the short and medium term (institutionalization and death).