As fraturas do quadril apresentam um risco de mortalidade de aproximadamente 30% em 1 ano.[28]North American Menopause Society. Management of osteoporosis in postmenopausal women: the 2021 position statement of the North American Menopause Society. Menopause. 2021 Sep 1;28(9):973-97.
https://www.doi.org/10.1097/GME.0000000000001831
http://www.ncbi.nlm.nih.gov/pubmed/34448749?tool=bestpractice.com
[112]Magaziner J, Simonsick EM, Kashner TM, et al. Predictors of functional recovery one year following hospital discharge for hip fracture: a prospective study. J Gerontol. 1990 May;45(3):M101-7.
http://www.ncbi.nlm.nih.gov/pubmed/2335719?tool=bestpractice.com
[113]Fredman L, Hawkes WG, Black S, et al. Elderly patients with hip fracture with positive affect have better functional recovery over 2 years. J Am Geriatr Soc. 2006 Jul;54(7):1074-81.
http://www.ncbi.nlm.nih.gov/pubmed/16866678?tool=bestpractice.com
Cerca de 25% a 75% dos adultos residentes na comunidade podem não recuperar seu nível de função antes da fratura.[114]Thorngren KG. Fractures in the elderly. Acta Orthop Scand Suppl. 1995 Oct;266:208-10.
http://www.ncbi.nlm.nih.gov/pubmed/8553854?tool=bestpractice.com
[115]Thorngren KG. Fractures in older persons. Disabil Rehabil. 1994 Jul-Sep;16(3):119-26.
http://www.ncbi.nlm.nih.gov/pubmed/7919395?tool=bestpractice.com
[116]Borgquist L, Ceder L, Thorngren KG. Function and social status 10 years after hip fracture. Prospective follow-up of 103 patients. Acta Orthop Scand. 1990 Oct;61(5):404-10.
http://www.ncbi.nlm.nih.gov/pubmed/2239162?tool=bestpractice.com
[117]Marottoli RA, Berkman LF, Cooney LM Jr. Decline in physical function following hip fracture. J Am Geriatr Soc. 1992 Sep;40(9):861-6.
http://www.ncbi.nlm.nih.gov/pubmed/1512379?tool=bestpractice.com
Os preditores de mortalidade incluem comorbidade significativa, função cognitiva pré-lesão baixa, eletrocardiograma (ECG) pré-operatório anormal, idade >85 anos e mobilidade pré-fratura diminuída.[97]Smith T, Pelpola K, Ball M, et al. Pre-operative indicators for mortality following hip fracture surgery: a systematic review and meta-analysis. Age Ageing. 2014 Jul;43(4):464-71.
https://academic.oup.com/ageing/article/43/4/464/2812257/Pre-operative-indicators-for-mortality-following
http://www.ncbi.nlm.nih.gov/pubmed/24895018?tool=bestpractice.com
[118]Marottoli RA, Berkman LF, Leo-Summers L, et al. Predictors of mortality and institutionalization after hip fracture: the New Haven EPESE (Established Populations for Epidemiologic Studies of the Elderly) cohort. Am J Public Health. 1994 Nov;84(11):1807-12.
http://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.84.11.1807
http://www.ncbi.nlm.nih.gov/pubmed/7977922?tool=bestpractice.com
As diretrizes recomendam a cirurgia no dia ou no dia seguinte à admissão para evitar o aumento do risco de mortalidade.[45]National Institute for Health and Care Excellence. Hip fracture: management. January 2023 [internet publication].
https://www.nice.org.uk/guidance/cg124
[46]Public Health Scotland. Scottish standards of care for hip fracture patients. May 2024 [internet publication].
https://publichealthscotland.scot/publications/scottish-standards-of-care-for-hip-fracture-patients
[47]Royal College of Physicians. Improving understanding: the National Hip Fracture Database report on 2021. 2022 [internet publication].
https://www.nhfd.co.uk/FFFAP/Reports.nsf/0/EA5D572779948D14802588D8005C1A99/$file/NHFD%202022%20Annual%20Report%20v1a.pdf
Cirurgia precoce:
Permite a mobilização precoce e a recuperação funcional
Está associado a menos dor e menor tempo de internação hospitalar.[98]Orosz GM, Magaziner J, Hannan EL, et al. Association of timing of surgery for hip fracture and patient outcomes. JAMA. 2004 Apr 14;291(14):1738-43.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1454713
http://www.ncbi.nlm.nih.gov/pubmed/15082701?tool=bestpractice.com
Os pacientes com afeto positivo que estão com boa saúde e moram com alguém têm melhor prognóstico para um bom desfecho.[112]Magaziner J, Simonsick EM, Kashner TM, et al. Predictors of functional recovery one year following hospital discharge for hip fracture: a prospective study. J Gerontol. 1990 May;45(3):M101-7.
http://www.ncbi.nlm.nih.gov/pubmed/2335719?tool=bestpractice.com
[116]Borgquist L, Ceder L, Thorngren KG. Function and social status 10 years after hip fracture. Prospective follow-up of 103 patients. Acta Orthop Scand. 1990 Oct;61(5):404-10.
http://www.ncbi.nlm.nih.gov/pubmed/2239162?tool=bestpractice.com
Idade avançada e aumento da estadia hospitalar resultam em prognóstico e desfecho inferiores quanto ao retorno para o estado funcional anterior à fratura.[112]Magaziner J, Simonsick EM, Kashner TM, et al. Predictors of functional recovery one year following hospital discharge for hip fracture: a prospective study. J Gerontol. 1990 May;45(3):M101-7.
http://www.ncbi.nlm.nih.gov/pubmed/2335719?tool=bestpractice.com