Palabras clave
Adultos mayores
Epidemiología
Mortalidad
Pronóstico
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Resumen
Objetivo: Identificar predictores de mortalidad en adultos mayores con fracturas de fémur proximal sometidos a cirugía dentro de un año. Método: Estudio con 142 pacientes ≥60 años, ingresados en un hospital de referencia para trauma ortopédico en la principal macrorregión de cobertura. Se utilizaron análisis univariados (chi-cuadrado, regresión de Cox) y métodos de Kaplan-Meier, Log-Rank, Breslow y Tarone-Ware. Resultados: La mortalidad fue del 30,5%, prevalente en mujeres (23,4%), con comorbilidades (28,1%), fractura trocantérea (16,3%), lado izquierdo afectado (17,7%) y uso de clavo intramedular (16,3%). Hubo mayor mortalidad entre pacientes con ASA I/II (28,4%), hemoglobina <12 g/dL (21%), sin transfusión sanguínea (23,4%), INR >1 (19%), estancia hospitalaria <7 días (22,7%), ingreso en UCI (20,6%) y sin entrenamiento de la marcha (23,4%). El análisis de Cox indicó edad >85 años (HR=3,31; p=0,034), ingreso en UCI (HR=2,54; p=0,009) y falta de entrenamiento de la marcha (HR=4,12; p<0,0001) como factores significativamente asociados con la mortalidad. Conclusión: La edad avanzada, el ingreso en UCI y la falta de entrenamiento de la marcha antes del alta hospitalaria son predictores de muerte dentro del año posterior a la cirugía de fractura de fémur proximal en ancianos.
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