NUTRITIONAL STATUS AND EVOLUTION OF ORTHOPEDIC URGENCY SURGERY IN THE ELDERLY

Abstract

Objective: We assessed patients of both sexes, aged over 60 years, admitted to the Institute of Orthopedics and Traumatology Godoy Moreira, Hospital das Clinicas, Faculty of Medicine, University of Sao Paulo, for emergency hip arthroplasty (hip fracture). Methods: The nutritional assessment included data on current weight and reported weight six months before the current condition, the index of nutritional risk, and complementary exams. For the categorical variables, contingency tables were compiled, which were analyzed by the chi square test. Where possible, the Student t test was used for unpaired samples, and in cases in which normality was not observed, the nonparametric (Mann Whiney) test was used. The following conditions were analyzed as co-variables: mortality, infections, re-admissions and complications (sum of the previous three). Thirty-eight patients aged over 60 years were analyzed: 15 men and 23 women, with a mean age of 79.21 (SD 9.12), and ages ranging from 60 to 94 (median 81 years). Results: No associations were found between age, weight, NRI, hemoglobin, albumin, IDL and handgrip and the co-variables. A strong relationship was observed between the number of previous diseases with mortality (p = 0.0012), infection (p = 0.002) and complications (p = 0.0305) but not with readmission (p = 0.640). A link was also found between hospitalization time and infection during hospitalization (p = 0.0016). Conclusions: It is observed that parameters related to number of diseases, hospitalization time and functionality, measured through the ability to carry out basic activities of daily living, were capable of predicting complications such as mortality, re-admissions and even re-infection, and may be useful in the preoperative evaluation of highly fragile elderly patients with hip fractures. Level of Evidence: Level II, prognostic studies.