Fatores associados ao tempo de internação em idosos abordados cirurgicamente após fratura proximal de fêmur.

Abstract

Objective: To investigate the factors associated with length of stay in elderly people treated surgically after proximal femur fracture. Methods: Cross-sectional study with elderly patients hospitalized for surgical treatment of proximal femur fracture in two public hospitals in Uberaba-MG was carried out from May to December 2022. Elderly people aged 60 or over who agreed to participate in the research were included. . The variables analyzed were length of hospital stay, personal aspects – sociodemographic, personal clinical – functional aspects and contextual aspects related to assistance and care. Descriptive analyzes were carried out for all study variables and non-parametric tests were used. Comparisons of medians were performed using the Mann-Whitney test, proportions using Pearson's chi-square test and correlations using Spearman's test. The significance adopted was 5%, with a confidence interval of 95%. Multivariate models were tested using multiple linear regression. Results: 44 elderly people participated, the majority of whom were female (59.1%), with low education (average 3.95 years) and partially sufficient income (47.7%). The majority of participants did not have mobility problems before the fracture and hospitalization (70.5%), however, a considerable number had already suffered two falls or more (41.9%). The average length of stay was 11.38 (± 4.13) days, ranging from 7 to 38 days. The main cause of the fracture was a fall from standing height (90.9%), being more common in the transtrochanteric region of the proximal femur (59.1%) and subject to stabilization (65.1%). In multivariate analyses, associations were observed between length of stay and practice of physical activity before the fracture and previous mobility, so that those who were more active had a shorter length of stay. Conclusion: Regardless of having preserved mobility before the fracture, the elderly had previous falls, which represents a public health problem. It is necessary to create programs aimed at preventing falls, focusing on improving the conditioning and physical performance of the elderly, monitoring elderly people who suffer falls and treating osteoporosis, thus ensuring a better quality of life for the elderly. The length of stay was influenced by the waiting time for the surgical procedure and the need for admission to the ICU for most elderly people, thus increasing hospital stay, as well as the level of physical activity and mobility prior to the fracture, physically active elderly people with Preserved mobility had shorter hospital stays. Furthermore, there is a need for hospital networks to create ways to reduce delays in surgeries, creating protocols in which the elderly are attended to within the first 48 hours of admission, thus reducing the risks of hospitalization, length of stay and health system expenditures.