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Previous issue date: 2016-08-29 / Introduction: Studies indicate that the population of elderly, of all places, the fracture occurring in the hip are the ones that have a higher impact on morbidity, higher rate of mortality, and high cost defendant for surgical treatment. The life expectancy of these patients can reduce by 15% in the first year and may reach 50% in the second year. Attention programs for the elderly with this profile of fragility can improve the clinically relevant results and reduce the high costs demanded by the treatments. Objective: Develop a program of attention to the elderly with hip fracture due to a fall, to be applied on a public network. Methods: a prospective cohort study on the implementation of the program and for the control group, retrospective of quantitative character. Results: were included in the study 182 elderly above 60 years diagnosed whit hip fracture. The sample was divided into two groups, the usual treatment (n=91) and treatment within the program (n=91). The treatment of choice is surgical. The average age was of 79,4 years, with prevalence of the female gender (74,2%). The most frequent morbidity was hypertension (72,5%). After the implementation of the program there was a reduction of the average time elapsed between the fracture and the beginning of the surgery (9 to 3 days), the average stay (from 16 to 7 days), the rate of infection of urinary tract (14,3% to 0,0%) and death rate (of 12,1% to 2,2%). There was no difference in the rate of readmissions within 30 days after discharge. Conclusion: The program of attention to the elderly with hip fracture applied in network modified the expected results, because reduced mortality, the average hospital stay, complications after surgery and the costs of the treatments during your stay. / Introdu??o: Estudos indicam que na popula??o de idosos dentre todos os s?tios de fratura, as que ocorrem no quadril s?o as que apresentam maior impacto na morbidade, maior taxa de mortalidade e alto custo demandado pelo tratamento cir?rgico. A expectativa de vida destes pacientes pode reduzir em 15% no primeiro ano, podendo chegar a 50% no segundo ano. Programas de aten??o a idosos com este perfil de fragilidade podem melhorar os resultados clinicamente relevantes e reduzir os custos altos demandados pelos tratamentos. Objetivo: Avaliar a efetividade de um programa de aten??o ao idoso com fratura de quadril decorrente de queda, para ser aplicado em uma rede p?blica de assist?ncia. M?todos: Estudo de coorte, prospectivo na aplica??o do programa e retrospectivo para o grupo controle, de car?ter quantitativo. Resultados: Foram inclu?dos no estudo 182 idosos acima de 60 anos com diagn?stico de fratura de quadril. A amostra foi dividida em dois grupos, de tratamento usual (n=91) e de tratamento dentro do programa (n=91). O tratamento de escolha foi cir?rgico. A m?dia de idade foi de 79,4 anos, com preval?ncia do g?nero feminino (74,2%). A morbidade mais frequente foi a hipertens?o (72,5%). Ap?s a implementa??o do programa houve redu??o do tempo m?dio decorrido entre a fratura e o in?cio da cirurgia (de 9 para 3 dias), da m?dia de perman?ncia (de 16 para 7 dias), da taxa de infec??o de trato urin?rio (de 14,3% para 0,0%) e da taxa de ?bito (de 12,1% para 2,2%). N?o houve diferen?a na taxa de readmiss?es em 30 dias ap?s a alta. Conclus?o: O programa de aten??o ao idoso com fratura de quadril, aplicado em rede, modificou os resultados esperados, porque reduziu a mortalidade, a m?dia de perman?ncia hospitalar, as complica??es p?s-operat?rias e os custos dos tratamentos durante a interna??o.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/7095 |
| Date | 29 August 2016 |
| Creators | Farias, Fatima Izabel Dornelles |
| Contributors | Terra, Newton Luiz |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Gerontologia Biom?dica, PUCRS, Brasil, Instituto de Geriatria e Gerontologia |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 4438661476953179033, 600, 600, 600, 2296420844541114010, -969369452308786627 |
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