[Perioperative complications and mortality in elderly patients following surgery for femoral fracture: prospective observational study].

Autor:	Barbosa TA; Universidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatu, SP, Brasil; Cooperativa dos Anestesiologistas de Ribeirão Preto, Ribeirão Preto, SP, Brasil. Electronic address: talita_ab1@hotmail.com., Souza AMF; Universidade Estadual Paulista (Unesp), Faculdade de Medicina, Graduação em Medicina, Botucatu, SP, Brasil., Leme FCO; Universidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatu, SP, Brasil., Grassi LDV; Universidade Estadual Paulista (Unesp), Faculdade de Medicina, Graduação em Medicina, Botucatu, SP, Brasil., Cintra FB; Santa Casa de São Carlos, São Carlos, SP, Brasil., Lima RME; Universidade Estadual Paulista (Unesp), Faculdade de Medicina, Serviço de Anestesiologia, Botucatu, SP, Brasil., Gumieiro DN; Universidade Estadual Paulista (Unesp), Faculdade de Medicina, Departamento de Cirurgia e Ortopedia, Botucatu, SP, Brasil., Lima LHNE; Universidade Estadual Paulista (Unesp), Faculdade de Medicina, Departamento de Anestesiologia, Botucatu, SP, Brasil.
Jazyk:	portugalština
Zdroj:	Brazilian journal of anesthesiology (Elsevier) [Braz J Anesthesiol] 2019 Nov - Dec; Vol. 69 (6), pp. 569-579. Date of Electronic Publication: 2019 Nov 11.
DOI:	10.1016/j.bjan.2019.09.004
Abstrakt:	Background and Objectives: Perioperative management of femoral fractures in elderly patients has been studied to determine modifiable causes of complications and death. The aim of this study was to evaluate the mortality rate and its causes in the elderly population with FF. We also evaluated perioperative complications and their association with postoperative mortality. Method: In this prospective and observational study, we evaluated 182 patients, by questionnaire and electronic medical record, from the moment of hospitalization to one year after surgery. Statistical analyzes using the multivariate Cox proportional hazards model and Kaplan-Meier curves were performed to detect independent mortality factors. Results: Fifty-six patients (30.8%) died within one year after surgery, and the main cause of death was infection followed by septic shock. The main complication, both preoperatively and postoperatively, was hydroelectrolytic disorder. For every one-unit (one-year) increase in age, the odds ratio for death increased by 4%. With each new preoperative complication, the odds ratio for death increased by 28%. Patients ASA III or IV had a 95% higher odds ratio for death than patiets ASA I or II. Conclusions: Increasing age and number of preoperative complications, in addition to ASA classification III or IV, were independent factors of increased risk of death in the population studied. The mortality rate was 30.8%, and infection followed by septic shock was the leading cause of death. (Copyright © 2019 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.)
Databáze:	MEDLINE
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