Complicaciones post operatorias de fractura de cadera: artroplastia vs osteosíntesis en el Hospital Nacional Adolfo Guevara Velasco de Cusco, 2017-2022
Date
2023-08-31Author
Qquenaya Tumpay, Gilmer Yordan
Rojas Ortiz de Zevallos, Milady Adriana
Advisor
Vargas Caballero, Uriel Raúl
Metadata
Show full item recordAbstract
Introducción: En la senectud la fractura proximal de fémur es un problema de salud que
va en aumento en los últimos años, el tratamiento por el cual se opta es el quirúrgico,
artroplastia u osteosíntesis, el cual ha demostrado mejores resultados. Objetivo:
Determinar la diferencia de complicaciones post operatorias en pacientes con fractura de
cadera tratados con artroplastia vs osteosíntesis en el Hospital Nacional Adolfo Guevara
Velasco-Cusco, 2017-2022. Método: Se llevó a cabo un estudio observacional,
correlacional, transversal y retrospectivo, donde se revisaron 151 historias clínicas de
pacientes intervenidos quirúrgicamente con artroplastia u osteosíntesis por fractura de
cadera que cumplieron los criterios de inclusión. Resultados: 57 (37.7%) pacientes
presentaron al menos una complicación, de ellos 35 (61.4%) fueron tratados con
artroplastia y 32 (38.6%) con osteosíntesis; se encontró un total de 75 complicaciones, la
artroplastia presento mayor frecuencia de complicaciones médicas siendo 31 (72.1%)
complicaciones y la osteosíntesis presentó mayor frecuencia de complicaciones propias
de la cirugía con 17 (53.1%) complicaciones. Se hallaron como características asociadas
a complicaciones post operatorias a: alta comorbilidad (OR=3.35, IC95%[1.50-7.46],
p=0.003), ASA III-IV (OR=3.21, IC95%[1.55-6.66], p=0.002), el tipo de fractura
(OR=2.57, IC95%[1.16-5.68], p=0.019) y estancia hospitalaria post cirugía mayor a 7
días (OR=15.17, IC95%[5.86-39.23], p=0.000). Conclusiones: 57 (37.7 %) pacientes
presentaron al menos una complicación post operatoria, la artroplastia presentó mayor
frecuencia de complicaciones médicas, y la osteosíntesis presentó mayor frecuencia de
complicaciones propias de la cirugía; se encontraron como características asociadas a la
presencia de complicaciones a la alta comorbilidad, ASA III-IV, tipo de fractura y
estancia hospitalaria post cirugía mayor a 7 días. Introduction: In old age, proximal femur fracture is a health problem that has been
increasing in recent years, the treatment chosen is surgical, arthroplasty or osteosynthesis,
which has shown better results. Objective: To determine the difference in postoperative
complications in patients with hip fracture treated with arthroplasty vs. osteosynthesis at
the Adolfo Guevara Velasco-Cusco National Hospital, 2017-2022. Method: An
observational, correlational, cross-sectional and retrospective study was carried out,
where 151 medical records of patients who underwent surgery with arthroplasty or
osteosynthesis for hip fracture who met the inclusion criteria were reviewed. Results: 57
(37.7%) patients presented at least one complication, of which 35 (61.4%) were treated
with arthroplasty and 32 (38.6%) with osteosynthesis; A total of 75 complications were
found, arthroplasty presented a higher frequency of medical complications with 31
(72.1%) complications and osteosynthesis presented a higher frequency of complications
typical of surgery with 17 (53.1%) complications. Characteristics associated with
postoperative complications were found to be: high comorbidity (OR=3.35, 95%CI[1.507.46],
p=0.003),
ASA
III-IV
(OR=3.21,
95%CI[1.55-6.66],
p=
0.002),
the
type
of
fracture
(OR=2.57,
95%CI[1.16-5.68],
p=0.019)
and
post-surgery
hospital
stay
longer
than
7
days
(OR=15.17,
95%CI[5.86-39.23],
p=0.000)
.
Conclusions:
57
(37.7%)
patients
presented
at
least one postoperative complication, arthroplasty presented a higher frequency of
medical complications, and osteosynthesis presented a higher frequency of complications
typical of surgery; Characteristics associated with the presence of complications were
found to be high comorbidity, ASA III-IV, type of fracture, and post-surgery hospital stay
longer than 7 days.