|Tipo di tesi||Tesi di laurea magistrale|
|Titolo||La frattura distale di femore nel paziente anziano: l'esperienza del reparto di ortogeriatria|
|Titolo in inglese||Distal femoral fracture in the elderly: the experience of the orthogeriatric department|
|Struttura||Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze|
|Corso di studi||MEDICINA E CHIRURGIA (D.M.270/04)|
|Data inizio appello||2019-07-17|
|Disponibilità||Accessibile via web (tutti i file della tesi sono accessibili)|
BACKGROUND Nowadays, older people represent, also in the developing countries, a large and growing percentage of the population. The population at high risk of fracture is meant to double from 2010 to 2040. Based on the National Plan for Chronicity and on the ISTAT analysis data (January 2018) chronicity is parallel increasing. This scenario is directly connected with the increased risk of falls for the elderly. The copresence of a chronicity condition, multimorbidity and fractures should be well managed during the hospitalization by a multidisciplinary team. The distal femoral facture representing the 8% of all femoral fractures and is actually poorly studied in the available literature. AIM The main purpose of this study is to analyse the case history of elderly patients with distal femoral fracture afferent to the orthopaedic ward dividing who has been followed by the geriatrician and who has not and the relationship of all the variables studied with mortality. This study aims also to underline the major risk of mortality for some groups of patients, and to compare the orthogeriatric experience with the more common traditional model of care in the management of the distal femoral fracture. METHODS We carried out a retrospective study on 98 patients, consecutively admitted in the orthopaedic ward of the Nuovo Ospedale S. Agostino-Estense in Baggiovara, with admission diagnosis of distal femoral fracture and aged >65. The study has been conducted within a long period, between January 2006 (when the orthogeriatric service was not active) and May 2019. We divided patients in two groups alive (64.3%) and dead (33,7%) respectively, in order to study differences. We used the statistic program SPSS® version 25 to complete the statistical analysis. RESULTS According to literature we found out that several condition can be related with a higher risk of death while other are surprisingly not related. In particular some comorbidities such as arrhythmic heart disease or stroke and the use of some drugs such as antipsychotics are significatively connected with death. Finally, high energy traumas result positively related with a higher survival in accordance with existing data. CONCLUSIONS Several ideas for a constant improvement of the patient management are obtainable from this study. Starting from spend more attention in patient with certain pharmacological anamnesis or comorbidities and going up to the upgrade of the orthogeriatric project in order to obtain better outcomes.