Factores de riesgo para la presentación de complicaciones médicas en enfermos con fractura de cadera / Risk factors for the development of medical complications in patients with hip fracture

Objetivo. Analizar las características de los pacientes hospitalizados con fractura de cadera y su evolución clínica, así como evaluar qué factores se asocian a un mayor riesgo de complicaciones médicas durante el ingreso. Métodos. Estudio prospectivo de los enfermos mayores de 65 años ingresados con fractura de cadera en el Servicio de Traumatología del Complexo Hospitalario Xeral-Calde de Lugo durante el año 2008. Se recogieron diferentes datos clínicos analíticos relativos al estado basal de salud, las características de la fractura y las complicaciones hospitalarias. Se determinaron los factores asociados al desarrollo de la variable compuesta por aparición de complicaciones médicas mayores o fallecimiento durante el ingreso hospitalario, mediante análisis univariable y multivariable. Resultados. Se estudió a 258 pacientes, media (DE) de edad 82,2 (9,5) años, el 76% mujeres. La fractura fue osteoporótica en el 96,8% y fueron operados el 92,6% de los enfermos. El índice de Barthel medio fue 72,9 (25,7) y el de comorbilidad de Charlson medio ajustado por edad 5,2 (1,5). El 63,9% presentó alguna complicación médica mayor durante el ingreso hospitalario. Fallecieron 15 enfermos (5,8%). Las siguientes variables se asociaron al riesgo de aparición de complicaciones médicas: índice de Barthel (OR=2,21; IC del 95%, 1,1-4,25; p=0,01), edad (OR=1,09; IC del 95%, 1,02-1,12; p=0,006), hemoglobina al ingreso (OR=0,76; IC del 95%, 0,62-0,93; p=0,01). Conclusiones. Los enfermos con fractura de cadera son ancianos frágiles, con un importante grado de dependencia y comorbilidad. Es posible identificar al ingreso a aquellos con un mayor riesgo de presentar complicaciones médicas durante su estancia hospitalaria(AU)

Objective. To evaluate the clinical features and outcome of inpatients with hip fracture and to investigate the clinical variables associated with the risk of medical complications. Methods. Prospective study of hip fracture patients aged 65 or more, admitted to the Department of Orthopaedic Surgery of the Xeral-Calde Hospital, in Lugo, Spain, in 2008. The different clinical and biochemical variables as regards the baseline health status and presentation features of the hip fracture and its complications were all recorded. The factors associated with the development of medical inpatient complications, including death, were determined, using univariate and multivariate analyses. Results. A total of 258 patients were studied. The mean age was 82.2 (9.5) years, and 76% were women. The fracture was osteoporotic in 96.8%, and 92.6% were treated surgically. The mean Barthel index was 72.9 (25.7) and the age adjusted Charlson comorbidity index was 5.2 (1.5). A total of 63.9% patients had a major medical complication during their hospital stay. Mortality was 5.8%. The following variables were associated with the development of medical inpatient complications: Barthel index (OR=2.21; 95% CI, 1.1-4.25; p=0,01), age (OR=1.09; 95% CI, 1.02-1.12; p=0.006), haemoglobin at admission (OR=0.76; 95% CI, 0.62-0.93; p=0.01). Conclusions. Patients with hip fracture are fragile elderly with a high degree of functional dependence and comorbidity. Those with a high risk of developing medical inpatient complications can be identified at admission(AU)

[Risk factors for the development of medical complications in patients with hip fracture]. / Factores de riesgo para la presentación de complicaciones médicas en enfermos con fractura de cadera.

OBJECTIVE: To evaluate the clinical features and outcome of inpatients with hip fracture and to investigate the clinical variables associated with the risk of medical complications. METHODS: Prospective study of hip fracture patients aged 65 or more, admitted to the Department of Orthopaedic Surgery of the Xeral-Calde Hospital, in Lugo, Spain, in 2008. The different clinical and biochemical variables as regards the baseline health status and presentation features of the hip fracture and its complications were all recorded. The factors associated with the development of medical inpatient complications, including death, were determined, using univariate and multivariate analyses. RESULTS: A total of 258 patients were studied. The mean age was 82.2 (9.5) years, and 76% were women. The fracture was osteoporotic in 96.8%, and 92.6% were treated surgically. The mean Barthel index was 72.9 (25.7) and the age adjusted Charlson comorbidity index was 5.2 (1.5). A total of 63.9% patients had a major medical complication during their hospital stay. Mortality was 5.8%. The following variables were associated with the development of medical inpatient complications: Barthel index (OR=2.21; 95% CI, 1.1-4.25; p=0,01), age (OR=1.09; 95% CI, 1.02-1.12; p=0.006), haemoglobin at admission (OR=0.76; 95% CI, 0.62-0.93; p=0.01). CONCLUSIONS: Patients with hip fracture are fragile elderly with a high degree of functional dependence and comorbidity. Those with a high risk of developing medical inpatient complications can be identified at admission.

Localized vasculitis of the gastrointestinal tract: a case report and literature review.

Localized gastrointestinal vasculitis is a rare condition. It may be observed as an incidental unexpected pathologic finding at the time of biopsy of an abdominal mass or may present as unexplained abdominal pain with or without unexplained lower gastrointestinal bleeding. In this report we describe a new case of localized polyarteritis nodosa with involvement of peripancreatic middle-sized blood vessels. A literature review of cases of localized gastrointestinal vasculitis was also conducted. A major point of concern is whether a single organ vasculitis of the gastrointestinal tract is actually a localized gastrointestinal vasculitis or simply an initial manifestation of a more severe systemic vasculitis. Due to this, in cases of localized gastrointestinal vasculitis a complete evaluation of the patient to exclude the presence of a systemic a potentially threatening systemic vasculitis is required.