RESUMO
We report a prospective study of the influence of various factors on the six-month mortality of 531 patients with subcapital hip fractures. We performed univariate and multivariate analyses on the 403 patients treated surgically. The most significant predictors of the six-month mortality were dementia, postoperative chest infection, malignant neoplasia, old age and deep-wound infection, in that order. A simple test of mental ability was the most significant prognostic indicator and this test should be included in future studies of the management of hip fractures in the elderly.
Assuntos
Fraturas do Quadril/mortalidade , Fatores Etários , Causas de Morte , Distribuição de Qui-Quadrado , Análise Discriminante , Feminino , Fraturas Espontâneas/epidemiologia , Fraturas Espontâneas/mortalidade , Fraturas Espontâneas/terapia , Fraturas do Quadril/epidemiologia , Fraturas do Quadril/terapia , Humanos , Testes de Inteligência , Masculino , Análise Multivariada , Prognóstico , Fatores de RiscoAssuntos
Vértebras Cervicais/lesões , Dança/lesões , Hematoma Epidural Craniano/diagnóstico por imagem , Doenças do Sistema Nervoso/diagnóstico por imagem , Sensação/fisiologia , Tomografia Computadorizada por Raios X , Ferimentos não Penetrantes/diagnóstico por imagem , Adulto , Vértebras Cervicais/diagnóstico por imagem , Humanos , Masculino , SíndromeRESUMO
A prospective study of factors which might help to predict mortality in patients with intracapsular fractures of the femoral neck has been undertaken. A multivariate analysis technique was used to analyse the collected data, and it was found that mental ability was the most significant variable; this factor had the greatest effect on outcome.
Assuntos
Fraturas do Colo Femoral/mortalidade , Idoso , Envelhecimento , Pinos Ortopédicos , Inglaterra , Feminino , Fraturas do Colo Femoral/fisiopatologia , Fraturas do Colo Femoral/cirurgia , Prótese de Quadril , Humanos , Masculino , Processos Mentais , Estudos Prospectivos , Fatores SocioeconômicosRESUMO
Eighty patients who had sustained a fracture of the tibial shaft were studied by scintigraphy using technetium-99m labelled methylene diphosphonate (99Tcm MDP) and a gamma camera. Static scintigrams were obtained in the early stages following injury and examined for the presence of 'cold spots' which may indicate loss of blood supply to fracture fragments; these were found in 10 per cent of cases but did not bear any definite relationship to the normal progression of union. Sequential dynamic scintigrams were obtained at intervals up to 20 weeks after fracture to determine whether a pattern of uptake of tracer could be identified which correlated with the subsequent progression of union, but no significant difference was observed between fractures healing promptly (less than 20 weeks) and those in which healing was delayed (greater than 20 weeks).
