| Abstract | CILJ ISTRAŽIVANJA:
Primarni cilj ove prospektivne studije bio je ustanoviti dobnu i spolnu strukturu bolesnika s prijelomima proksimalnog dijela bedrene kosti, utvrditi težinu općeg stanja, odnosno ASA statusa istih, vrijeme proteklo od prijma do operacije, kao i ukupno trajanje hospitalizacije, zatim učestalost pojedinih tipova prijeloma, kao i operacijskih zahvata koji su izvođeni radi njihove sanacije te dobivene rezultate usporediti rezultatima iz dostupne svjetske literature.
MATERIJALI I METODE:
Za izradu ovog istraživanja bilo je nužno prikupiti podatke o bolesnicima operiranima zbog prijeloma proksimalnog dijele bedrene kosti u KBC-u Split u 2014. godini.
REZULTATI:
Bolesnika s ASA statusom nižim od ASA 2 bilo je 2,934%, onih s ASA statusom između 2 i 3 je bilo 40,857%, a onih s ASA statusom jednakim 3 ili višim bilo je 56,209%. Prosječni ASA status bio je 2,589.
Od 438 ispitanika obuhvaćenih ovom studijom 74,430% bile su žene, a 25,570% bili su muškarci.
Prosječna dob ispitanika u trenutku operacije bila je 78,244 godina. Najveći broj bolesnika zahvaćao je redom dobnu skupinu od 80 do 84 godina - 104 bolesnika.
Bolesnici su imali redom po učestalosti sljedeće tipove prijeloma: prijelom vrata femura 52,423%, pertrohanterni prijelom 41,630% i subtrohanterni prijelom 5,947%.
Najčešći operacijski zahvat s obzirom na ukupan broj prijeloma proksimalnog femura je redom: PFNA - 36,842%..
Od 438 hospitaliziranih bolesnika za vrijeme hospitalizacije umrlo ih je 6, što čini postotak od 1,370% umrlih za vrijeme boravka u bolnici. Prosječno vrijeme proteklo od dana prijma do dana kad je izvedena operacija je 2,8 dana. Prosječno trajanje hospitalizacije računano od datuma prijema do datuma otpusta iz bolnice je 11,6 dana.
Gledajući izolirano pertrohanterne prijelome, muškarci su zauzeli 13,986% bolesnika, dok su žene žene činile 86,014% .
Gledajući izolirano pertrohanterne prijelome, najčešće izvedeni operacijski zahvat bio je PFNA
- 76,757.
Gledajući pertrohanterne prijelome izolirano, najviše je bilo bolesnika u dobi od 80 do 84 godine - 41 bolesnik.Prosjek dobi za pertrohanterne prijelome bio je 78,7 godina.
Spolna raspodjela gledajući izolirano prijelom vrata femura bila je 72,766% žena i 27,234% muškaraca.
Gledajući izolirano prijelome vrata femura, najviše je bilo bolesnika u dobi od 80 do 84 godina- 59 bolesnika.
rosjek dobi bolesnika s prijelomom vrata femura bila je 78,430 godina.
Gledajući izolirano prijelom vrata femura, najčešće izvedeni operacijski zahvat je PEP(AUSTIN - MOORE) - 45,107%.
Od bolesnika kojima je bila ugrađivana parcijalna endoproteza Austin - Moore bilo je 32,1% bolesnika s ASA statusom 2 do 3 i 67,9% bolesnika s ASA statusom 3 i više. Prosjek dobi bolesnika kojima je ugrađena parcijalna endoproteza Austin - Moore : 84,459 godina.
ZAKLJUČCI
Ovom studijom potvrđeni su navodi iz literature o frakturama proksimalnog femura kao značajnom problemu u traumatologiji, kao i na socijalno-ekonomskoj razini. Rezultati ovog istraživanja većim dijelom slažu se s rezultatima dostupnima u svjetskoj literature. Bolesnici u KBC-u Split bili su u prosjeku nekoliko godina mlađi od bolesnika u Švedskoj i Norveškoj, s kojima smo imali najveći broj usporedbi, kao i u ostalim zemljama koje se navode. Od ostalih značajnijih razlika ističu se razlike u učestalosti pojedinih operacijskih zahvata, tako da je gledajući sve prijelome ukupno u KBC-u Split, najčešća operacijska metoda PFNA, a najrjeđa DHS, dok je u Norveškoj, primjerice, DHS najčešća, a PFNA jedna od najrjeđih metoda. |
| Abstract (english) | THE AIM OF THE STUDY
The primary aim of this study was to establish the age and sex structure of patients with hip fractures, to establish how difficult their general condition was (the ASA status), the time from the reception until the operation and the full length of the hospital stay, the frequency of the types of fractures, and also the surgical procedures which were preformed and to compare those results with those available in other world publications.
MATERIALS AND METHODS
For this study it was necessary to collect the data of the patients who were operated due to hip fracture in HKP Split in the year 2014. The data was collected from the surgical protocol of the Department of traumatology and the Department of orthopedic surgery.
RESULTS
There were 2,934% patients with ASA status lower than ASA 2, 40,857% were between ASA 2 and ASA 3, and 56,209% were ASA 3 and higher. The average ASA status was 2,589.
Out of 438 patients 74,430% were women and 25,570 were men.
The average age at the time was 78,244 years. The largest age group was the one from 80 to 84 years of age - 104 patients.
The patients had 52,423% femoral neck fractures, 41,630% pertrochanteric fractures, and 5,947% subtrochanteric fractures.
The most frequent surgical procedure considering the total number of fractures was PFNA - 36,842%.
Out of 438 patients 6 of them died during hospitalization, which makes 1,370% fatal cases during hospitalization.
The average time from the day of the reception until the day of the operation was 2,8 days.
Analyzing the pertrochanteric fractures solely there were 13,986% men and 86,014 women.
Analyzing pertrochanteric fractures solely the most frequent operation was PFNA - 76,757%. The largest age group of the patients with pertrochanteric fractures was 80 to 84 years - 41 patient. The average age of patients with pertrochanteric fractures was 78,7 years.
Analyzing solely femoral neck fractures there were 72,766% women and 27,234% women.
The largest age group was 80 to 84 years - 59 patients.
The average age of patients with femoral neck fractures was 78,430 years.
Analyzing femoral neck fractures solely, the most frequent surgical procedure was HEMIPROSTHESIS (AUSTIN - MOORE) - 45,107%.
Analyzing patients with AUSTIN - MOORE prosthesis solely there were 32,1% patients with ASA status between 2 and 3, and 67,9% of them with ASA status 3 and higher. The average age of patients with AUSTIN - MOORE prosthesis was 84,459 years.
CONCLUSION
This study confirmed the claims found in literature about hip fractures as an important problem in traumatology and also on a socio-economical level. The results of this study are in most parts similar to the results available in foreign publications. The patients in HKP Split are, on the other hand a few years younger than those in Sweden and Norway, with whom most comparisons were made, and those in other countries. Other significant differences are the difference in the frequency of surgical procedures, so analyzing all fractures in HKP Split the most common procedure was PFNA, and DHS is the rarest, in contrast to Norway, where DHS was the most frequent procedure, and PFNA was one of the rarest. |
