Abstract Objective To evaluate the factors associated with readmission within 30 days after discharge (R30) and in-hospital mortality (IHM) in elderly patients undergoing proximal femur fracture surgery (PFF). Methods Retrospective cohort with data from 896 medical records of elderly (≥ 60 years) patients submitted to PFF surgery in a Brazilian hospital between November 2014 and December, 2019. The patients included were followed-up from the date of hospitalization for surgery up to 30 days after discharge. As independent variables, we evaluated gender, age, marital status, pre- and postoperative hemoglobin (Hb), international normalized ratio, time of hospitalization related to the surgery, door-surgery time, comorbidities, previous surgeries, use of medications, and the American Society of Anesthesiologists (ASA) score. Results The incidence of R30 was 10.2% (95% confidence interval [CI]: 8.3-12.3%), and the incidence of IHM was 5.7% (95%CI: 4.3-7.4%). Regarding R30, hypertension (odds ratio [OR]: 1.71; 95%CI: 1.03–2.96), and regular use of psychotropic drugs (OR: 1.74; 95%CI: 1.12–2.72) were associated in the adjusted model. In the case of IHM, higher chances were associated with chronic kidney disease (CKD) (OR: 5.80; 95%CI: 2.64–12.31), longer hospitalization time (OR: 1.06; 95%CI: 1.01–1.10), and R30 (OR: 3.60; 95%CI: 1.54–7.96). Higher preoperative Hb values were associated with a lower chance of mortality (OR: 0.73; 95%CI: 0.61–0.87). Conclusion Findings suggest that the occurrence of these outcomes is associated with comorbidities, medications, and Hb. 3 R (R30 inhospital (IHM PFF. . (PFF) 89 ≥ ( 6 years 201 December 2019 followedup followed variables gender age status pre Hb, , (Hb) doorsurgery door comorbidities surgeries medications ASA (ASA score R3 102 10 2 10.2 95% 95 (95 CI [CI] 8.312.3%, 83123 8.3 12.3% 8 12 8.3-12.3%) 57 5 7 5.7 95%CI 95CI (95%CI 4.37.4%. 4374 4.3 7.4% 4 4.3-7.4%) odds OR [OR] 1.71 171 1 71 1.03–2.96, 103296 1.03–2.96 03 96 1.03–2.96) (OR 1.74 174 74 1.12–2.72 112272 72 model CKD (CKD 5.80 580 80 2.64–12.31, 2641231 2.64–12.31 64 31 2.64–12.31) 1.06 106 06 1.01–1.10, 101110 1.01–1.10 01 1.01–1.10) 3.60 360 1.54–7.96. 154796 1.54–7.96 54 1.54–7.96) 0.73 073 0 73 0.61–0.87. 061087 0.61–0.87 61 87 0.61–0.87) (R3 (PFF 20 (Hb 10. 9 (9 [CI 312 8.312.3% 8312 83 8. 123 12.3 8.3-12.3% 5. 37 4.37.4% 437 43 4. 7.4 4.3-7.4% [OR 1.7 17 10329 1.03–2.9 1.12–2.7 11227 5.8 58 264123 2.64–12.3 1.0 10111 1.01–1.1 3.6 36 15479 1.54–7.9 0.7 07 06108 0.61–0.8 (R 8.312.3 831 12. 8.3-12.3 4.37.4 7. 4.3-7.4 1. 1032 1.03–2. 1.12–2. 1122 26412 2.64–12. 1011 1.01–1. 3. 1547 1.54–7. 0. 0610 0.61–0. 8.312. 8.3-12. 4.37. 4.3-7. 103 1.03–2 1.12–2 112 2641 2.64–12 101 1.01–1 154 1.54–7 061 0.61–0 8.312 8.3-12 4.37 4.3-7 1.03– 1.12– 11 264 2.64–1 1.01– 15 1.54– 0.61– 8.31 8.3-1 4.3- 1.03 1.12 26 2.64– 1.01 1.54 0.61 8.3- 1.1 2.64 1.5 0.6 2.6 2.
Resumo Objetivo Avaliar os fatores associados à reinternação em até 30 dias após a alta (R30) e à mortalidade intra-hospitalar (MIH) em idosos submetidos a cirurgia por fratura do fêmur proximal (FFP). Métodos Coorte retrospectiva com dados de 896 prontuários de idosos (≥ 60 anos) submetidos a cirurgia de FFP em hospital brasileiro, no período entre novembro de 2014 a dezembro de 2019. Os pacientes incluídos foram acompanhados desde a data de internação para a cirurgia até 30 dias após a alta. Como variáveis independentes, foram avaliados o sexo, idade, estado civil, hemoglobina (Hb) pré e pós-operatória, razão normalizada internacional, tempo da internação relacionada à cirurgia, tempo porta cirurgia, comorbidades, cirurgias prévias, uso de medicamentos e escore da American Society of Anesthesiologists (ASA). Resultados A incidência de R30 foi de 10,2% (intervalo de confiança [IC] 95%: 8,3–12,3%) e a de MIH foi 5,7% (IC95%: 4,3–7,4%). Referente a R30, no modelo ajustado, associaram-se ter hipertensão (odds ratio [OR]: 1,71; IC95%: 1,03–2,96), uso regular de medicamentos psicotrópicos (OR: 1,74; IC95%: 1,12–2,72). Tratando-se da MIH, maiores chances estiveram associadas à doença renal crônica (DRC) (OR: 5,80; IC95%: 2,64–12,31), maior tempo de internação (OR: 1,06; IC95%: 1,01–1,10) e R30 (OR: 3,60; IC95%: 1,54–7,96). Maiores valores de Hb pré-operatória associaram-se à menor chance de mortalidade (OR: 0,73; IC95%: 0,61–0,87). Conclusão Os achados sugerem que a ocorrência destes desfechos está associada à comorbidades, medicamentos e Hb. 3 R (R30 intrahospitalar intra hospitalar (MIH FFP. . (FFP) 89 ≥ ( 6 anos brasileiro 201 2019 independentes sexo idade civil (Hb pósoperatória, pósoperatória pós operatória, operatória pós-operatória internacional comorbidades prévias ASA. ASA (ASA) R3 102 10 2 10,2 intervalo IC [IC 95% 95 8,3–12,3% 83123 8 12 57 5 7 5,7 IC95% IC95 (IC95% 4,3–7,4%. 4374 4,3–7,4% 4 4,3–7,4%) ajustado associaramse associaram se odds OR [OR] 1,71 171 1 71 1,03–2,96, 103296 1,03–2,96 , 03 96 1,03–2,96) (OR 1,74 174 74 1,12–2,72. 112272 1,12–2,72 72 1,12–2,72) Tratandose Tratando DRC (DRC 5,80 580 80 2,64–12,31, 2641231 2,64–12,31 64 31 2,64–12,31) 1,06 106 06 1,01–1,10 101110 01 3,60 360 1,54–7,96. 154796 1,54–7,96 54 1,54–7,96) préoperatória 0,73 073 0 73 0,61–0,87. 061087 0,61–0,87 61 87 0,61–0,87) (R3 (FFP 20 (ASA 10, 9 8,3–12,3 8312 5, IC9 (IC95 437 4,3–7,4 [OR 1,7 17 10329 1,03–2,9 11227 1,12–2,7 5,8 58 264123 2,64–12,3 1,0 1,01–1,1 10111 3,6 36 15479 1,54–7,9 0,7 07 06108 0,61–0,8 (R 8,3–12, 831 (IC9 43 4,3–7, 1, 1032 1,03–2, 1122 1,12–2, 26412 2,64–12, 1,01–1, 1011 3, 1547 1,54–7, 0, 0610 0,61–0, 8,3–12 83 (IC 4,3–7 103 1,03–2 112 1,12–2 2641 2,64–12 1,01–1 101 154 1,54–7 061 0,61–0 8,3–1 4,3– 1,03– 11 1,12– 264 2,64–1 1,01– 15 1,54– 0,61– 8,3– 4,3 1,03 1,12 26 2,64– 1,01 1,54 0,61 8,3 4, 1,1 2,64 1,5 0,6 8, 2,6 2,