Factores relacionados con la necesidad de soporte vasoactivo o ventilatorio en el postoperatorio de fractura de cadera en el Hospital Fundación Santa Fe de Bogotá entre los años 2018 a 2022

INTRODUCCIÓN Las fracturas de cadera representan un importante problema de salud pública, asociado con altos costos hospitalarios y un impacto significativo en la calidad de vida relacionada con la salud reportada por los pacientes. En los adultos mayores, también contribuyen a una mayor morbilidad...

Full description

Autores:
Lizarazo Jimenez, Maria Jose
Campaña Perilla, Laura Andrea
Bernate, Juan David
Sanint Castro, Valentina
Patiño Patiño, Aldo Fernando
Tipo de recurso:
https://purl.org/coar/resource_type/c_7a1f
Fecha de publicación:
2025
Institución:
Universidad El Bosque
Repositorio:
Repositorio U. El Bosque
Idioma:
spa
OAI Identifier:
oai:repositorio.unbosque.edu.co:20.500.12495/15327
Acceso en línea:
https://hdl.handle.net/20.500.12495/15327
Palabra clave:
Fractura de cadera
Unidad de cuidados intensivos
Factores asociados
Geriatría
Ortogeriatría
Hip fracture
Intensive care unit
Associated factors
Geriatrics
Orthogeriatrics
WB 115
Rights
License
Acceso abierto
id UNBOSQUE2_79c0dab5f748722321ae3b3964a6058f
oai_identifier_str oai:repositorio.unbosque.edu.co:20.500.12495/15327
network_acronym_str UNBOSQUE2
network_name_str Repositorio U. El Bosque
repository_id_str
dc.title.none.fl_str_mv Factores relacionados con la necesidad de soporte vasoactivo o ventilatorio en el postoperatorio de fractura de cadera en el Hospital Fundación Santa Fe de Bogotá entre los años 2018 a 2022
dc.title.translated.none.fl_str_mv Factors Associated with the Need for Vasopressor or Ventilatory Support Following Hip Fracture Surgery at Fundación Santa Fe de Bogotá (2018–2022)
title Factores relacionados con la necesidad de soporte vasoactivo o ventilatorio en el postoperatorio de fractura de cadera en el Hospital Fundación Santa Fe de Bogotá entre los años 2018 a 2022
spellingShingle Factores relacionados con la necesidad de soporte vasoactivo o ventilatorio en el postoperatorio de fractura de cadera en el Hospital Fundación Santa Fe de Bogotá entre los años 2018 a 2022
Fractura de cadera
Unidad de cuidados intensivos
Factores asociados
Geriatría
Ortogeriatría
Hip fracture
Intensive care unit
Associated factors
Geriatrics
Orthogeriatrics
WB 115
title_short Factores relacionados con la necesidad de soporte vasoactivo o ventilatorio en el postoperatorio de fractura de cadera en el Hospital Fundación Santa Fe de Bogotá entre los años 2018 a 2022
title_full Factores relacionados con la necesidad de soporte vasoactivo o ventilatorio en el postoperatorio de fractura de cadera en el Hospital Fundación Santa Fe de Bogotá entre los años 2018 a 2022
title_fullStr Factores relacionados con la necesidad de soporte vasoactivo o ventilatorio en el postoperatorio de fractura de cadera en el Hospital Fundación Santa Fe de Bogotá entre los años 2018 a 2022
title_full_unstemmed Factores relacionados con la necesidad de soporte vasoactivo o ventilatorio en el postoperatorio de fractura de cadera en el Hospital Fundación Santa Fe de Bogotá entre los años 2018 a 2022
title_sort Factores relacionados con la necesidad de soporte vasoactivo o ventilatorio en el postoperatorio de fractura de cadera en el Hospital Fundación Santa Fe de Bogotá entre los años 2018 a 2022
dc.creator.fl_str_mv Lizarazo Jimenez, Maria Jose
Campaña Perilla, Laura Andrea
Bernate, Juan David
Sanint Castro, Valentina
Patiño Patiño, Aldo Fernando
dc.contributor.advisor.none.fl_str_mv Mendoza Obirne, Mario
dc.contributor.author.none.fl_str_mv Lizarazo Jimenez, Maria Jose
Campaña Perilla, Laura Andrea
Bernate, Juan David
Sanint Castro, Valentina
Patiño Patiño, Aldo Fernando
dc.contributor.orcid.none.fl_str_mv Lizarazo Jimenez, Maria [0000-0002-2111-4440]
dc.subject.none.fl_str_mv Fractura de cadera
Unidad de cuidados intensivos
Factores asociados
Geriatría
Ortogeriatría
topic Fractura de cadera
Unidad de cuidados intensivos
Factores asociados
Geriatría
Ortogeriatría
Hip fracture
Intensive care unit
Associated factors
Geriatrics
Orthogeriatrics
WB 115
dc.subject.keywords.none.fl_str_mv Hip fracture
Intensive care unit
Associated factors
Geriatrics
Orthogeriatrics
dc.subject.nlm.none.fl_str_mv WB 115
description INTRODUCCIÓN Las fracturas de cadera representan un importante problema de salud pública, asociado con altos costos hospitalarios y un impacto significativo en la calidad de vida relacionada con la salud reportada por los pacientes. En los adultos mayores, también contribuyen a una mayor morbilidad y mortalidad, siendo más frecuentes en esta población debido a la disminución de la densidad mineral ósea, cambios en las propiedades del hueso, debilidad muscular y mayor riesgo de caídas. Aunque estudios previos han identificado asociaciones entre factores clínicos o funcionales y el ingreso a la unidad de cuidados intensivos (UCI) en adultos mayores con fractura de cadera, estos factores han sido evaluados frecuentemente de forma aislada y sin considerar interacciones entre múltiples dominios. OBJETIVO Evaluar de forma integral los factores sociodemográficos, clínicos, paraclínicos, funcionales y quirúrgicos asociados con el ingreso a la unidad de cuidados intensivos (UCI). MATERIALES Y MÉTODOS Se realizó un estudio de cohortes retrospectivo con componente analítico. La población fue descrita mediante frecuencias, porcentajes, medias con desviaciones estándar o medianas con rangos intercuartílicos, según la distribución evaluada con la prueba de Shapiro-Wilk. Las asociaciones entre las variables independientes y el ingreso a UCI se exploraron mediante análisis bivariado (prueba t de Student, U de Mann–Whitney, chi-cuadrado o regresión logística binaria, según el tipo de variable). Las variables significativas se incluyeron en modelos multivariados luego de verificar la ausencia de multicolinealidad. Se construyeron modelos de regresión logística agrupados por dominios (sociodemográfico, comorbilidades, índices clínicos y paraclínicos), además de un modelo final robusto que integró las variables más relevantes. Se estimaron razones de odds (OR) con intervalos de confianza (IC) del 95%. RESULTADOS Entre los 431 pacientes incluidos, el 16.9% requirió ingreso a la unidad de cuidados intensivos (UCI). En el modelo multivariado integral, los factores clínicos y funcionales más fuertemente asociados con el ingreso a UCI fueron la insuficiencia cardiaca (OR: 10.63; IC 95%: 3.25–34.79), el delirium preoperatorio evaluado mediante la escala Confusion Assessment Method (CAM) (OR: 4.37; IC 95%: 1.57–12.19), el antecedente de caídas previas (OR: 1.54; IC 95%: 1.03–2.33), y el número de unidades de glóbulos rojos transfundidas (OR: 1.66; IC 95%: 1.28–2.16). CONCLUSIONES El ingreso a la unidad de cuidados intensivos (UCI) después de una cirugía por fractura de cadera en adultos mayores estuvo asociado principalmente por la vulnerabilidad clínica y funcional. Incorporar estos factores en la evaluación preoperatoria podría mejorar la estratificación del riesgo y la atención perioperatoria en contextos ortogeriátricos.
publishDate 2025
dc.date.accessioned.none.fl_str_mv 2025-07-28T16:31:07Z
dc.date.available.none.fl_str_mv 2025-07-28T16:31:07Z
dc.date.issued.none.fl_str_mv 2025-07
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_7a1f
dc.type.local.spa.fl_str_mv Tesis/Trabajo de grado - Monografía - Especialización
dc.type.coar.none.fl_str_mv https://purl.org/coar/resource_type/c_7a1f
dc.type.driver.none.fl_str_mv info:eu-repo/semantics/bachelorThesis
dc.type.coarversion.none.fl_str_mv https://purl.org/coar/version/c_ab4af688f83e57aa
format https://purl.org/coar/resource_type/c_7a1f
dc.identifier.uri.none.fl_str_mv https://hdl.handle.net/20.500.12495/15327
dc.identifier.instname.spa.fl_str_mv instname:Universidad El Bosque
dc.identifier.reponame.spa.fl_str_mv reponame:Repositorio Institucional Universidad El Bosque
dc.identifier.repourl.none.fl_str_mv repourl:https://repositorio.unbosque.edu.co
url https://hdl.handle.net/20.500.12495/15327
identifier_str_mv instname:Universidad El Bosque
reponame:Repositorio Institucional Universidad El Bosque
repourl:https://repositorio.unbosque.edu.co
dc.language.iso.fl_str_mv spa
language spa
dc.relation.references.none.fl_str_mv 1. Wu A M, Bisignano C, James SL, Abady GG, Abedi A, Abu Gharbieh E, et al. Global, regional, and national burden of bone fractures in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet Healthy Longev. 2021;2(9):e580–92. https://doi.org/10.1016/S2666-7568(21)00102-0
2. Deutschbein J, Lindner T, Möckel M, Pigorsch M, Gilles G, Stöckle U, et al. Health-related quality of life and associated factors after hip fracture. Results from a six-month prospective cohort study. PeerJ. 2023;11:e14671. https://doi.org/10.7717/peerj.14671
3. Weycker D, Li X, Barron R, Bornheimer R, Chandler D. Hospitalizations for osteoporosis-related fractures: economic costs and clinical outcomes. Bone Rep. 2016;5:186–91. https://doi.org/10.1016/j.bonr.2016.07.005
4. Dubljanin‑Raspopović E, Marković‑Denić L, Marinković J, Nedeljković U, Bumbaširević M, et al. Does early functional outcome predict 1‑year mortality in elderly patients with hip fracture? Clin Orthop Relat Res. 2013 Aug;471(8):2703–10. https://doi.org/10.1007/s11999-013-2955-1
5. Colón Emeric CS, Kuchibhatla M, Pieper C, et al. The contribution of hip fracture to risk of subsequent fractures: data from two longitudinal studies. Osteoporos Int. 2003 Nov;14(11):879–83. https://doi.org/10.1007/s00198-003-1460-x
6. Marks R, Allegrante JP, MacKenzie CR, Lane JM. Hip fractures among the elderly: causes, consequences and control. Ageing Res Rev. 2003 Jan;2(1):57–93. https://doi.org/10.1016/S1568-1637(02)00045-4
7. Birge SJ. Osteoporosis and hip fracture. Clin Geriatr Med. 1993 Feb;9(1):69-86. PMID: 8443741.
8. Yang Y, Komisar V, Shishov N, Lo B, Korall AMB, Feldman F, et al. The effect of fall biomechanics on risk for hip fracture in older adults: a cohort study of video captured falls in long term care. J Bone Miner Res. 2020 Oct;35(10):1914–22. https://doi.org/10.1002/jbmr.4048
9. Lloyd R, Baker G, MacDonald J, Thompson NW. Co-morbidities in Patients with a Hip Fracture. Ulster Med J. 2019 Sep;88(3):162–6. Epub 2019 Oct 11. PMID: 31619850
10. Roche JJW, Wenn RT, Sahota O, Moran CG. Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study. BMJ. 2005 Dec 10;331(7529):1374. doi: 10.1136/bmj.38643.663843.55.
11. Gillespie WJ. Extracts from "clinical evidence": hip fracture. BMJ. 2001 Apr 21;322(7292):968–75. https://doi.org/10.1136/bmj.322.7292.968.
12. Veronese N, Maggi S. Epidemiology and social costs of hip fracture. Injury. 2018 Aug;49(8):1458–60. https://doi.org/10.1016/j.injury.2018.04.015
13. Pech-Ciau BA, Lima-Martínez EA, Espinosa-Cruz GA, Pacho-Aguilar CR, Huchim-Lara O, Alejos-Gómez RA. Fractura de cadera en el adulto mayor: epidemiología y costos de la atención. Acta Ortop Mex. 2021;35(4):341–7. https://doi.org/10.35366/103314
14. Cooper C, Campion G, Melton LJ. Hip fractures in the elderly: a world-wide projection. Osteoporos Int. 1992 Nov;2(6):285–9. https://doi.org/10.1007/BF01623184
15. Alswat KA. Gender disparities in osteoporosis. J Clin Med Res. 2017 May;9(5):382–7. https://doi.org/10.14740/jocmr2970w
16. Kanis JA, Odén A, McCloskey EV, Johansson H, Wahl DA, Cooper C; IOF Working Group on Epidemiology and Quality of Life. A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int. 2012 Sep;23(9):2239–56. https://doi.org/10.1007/s00198-012-1964-3
17. Neer RM. The evolutionary significance of vitamin D, skin pigment, and ultraviolet light. Am J Phys Anthropol. 1975 Nov;43(3):409–16. https://doi.org/10.1002/ajpa.1330430322
18. Kazley JM, Banerjee S, Abousayed MM, Rosenbaum AJ. Classifications in brief: Garden classification of femoral neck fractures. Clin Orthop Relat Res. 2018 Feb;476(2):441–5. https://doi.org/10.1007/s11999.0000000000000066
19. Meinberg EG, Agel J, Roberts CS, Karam MD, Kellam JF. Fracture and dislocation classification compendium–2018. J Orthop Trauma. 2018 Jan;32 Suppl 1:S1–S170. https://doi.org/10.1097/BOT.0000000000001063
20. Masionis P, Uvarovas V, Mazarevičius G, Popov K, Venckus Š, Baužys K, Porvaneckas N. The reliability of a Garden, AO and simple II stage classifications for intracapsular hip fractures. Orthop Traumatol Surg Res. 2019 Feb;105(1):29–33. https://doi.org/10.1016/j.otsr.2018.11.007.
21. Lewis SR, Macey R, Gill JR, Parker MJ, Griffin XL. Cephalomedullary nails versus extramedullary implants for extracapsular hip fractures in older adults. Cochrane Database Syst Rev. 2022 Jan 14;2022(1):CD000093. https://doi.org/10.1002/14651858.CD000093.pub6
22. Varacallo MA, Luo TD, Johanson NA. Total hip arthroplasty techniques [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan– [updated 2023 Aug 4; cited 2025 Jul 25]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507864/
23. Kannus P, Parkkari J, Sievänen H, Heinonen A, Vuori I, Järvinen M. Epidemiology of hip fractures. Bone. 1996 Jan;18(1 Suppl):57S–63S. doi: 10.1016/8756 3282(95)00381 9
24. Palm H. Hip fracture: the choice of surgery. In: Falaschi P, Marsh D, editors. Orthogeriatrics: The Management of Older Patients with Fragility Fractures. 2nd ed. Cham (CH): Springer; 2021. p. 125–41. https://doi.org/10.1007/978-3-030-48126-1_9.
25. Klestil T, Röder C, Stotter C, Winkler B, Nehrer S, Lutz M, et al. Impact of timing of surgery in elderly hip fracture patients: a systematic review and meta analysis. Sci Rep. 2018 Sep 17;8(1):13933. https://doi.org/10.1038/s41598-018-32098-7
26. Schep NWL, Heintjes RJ, Martens EP, van Dortmont LMC, van Vugt AB. Retrospective analysis of factors influencing the operative result after percutaneous osteosynthesis of intracapsular femoral neck fractures. Injury. 2004 Oct;35(10):1003–9. https://doi.org/10.1016/j.injury.2003.07.001.
27. Parker MJ, Gurusamy KS. Internal fixation implants for intracapsular hip fractures in adults. Cochrane Database Syst Rev. 2001;(4):CD001467. https://doi.org/10.1002/14651858.CD001467.
28. Nonne D, Sanna F, Bardelli A, Milano P, Rivera F. Use of a dual mobility cup to prevent hip early arthroplasty dislocation in patients at high falls risk. Injury. 2019 Aug;50(Suppl 4):S26–9. https://doi.org/10.1016/j.injury.2019.01.022.
29. Pincus D, Ravi B, Wasserstein D, Huang A, Paterson JM, Nathens AB, et al. Association between wait time and 30 day mortality in adults undergoing hip fracture surgery. JAMA. 2017 Nov 28;318(20):1994–2003. https://doi.org/10.1001/jama.2017.17606.
30. Lin DY, Woodman R, Oberai T, Brown B, Morrison C, Kroon H, et al. Association of anesthesia and analgesia with long term mortality after hip fracture surgery: an analysis of the Australian and New Zealand Hip Fracture Registry. Reg Anesth Pain Med. 2023 Jan;48(1):14–21. https://doi.org/10.1136/rapm-2022-103550
31. Ma M, Lu H, Fu Z, Zhang P, Jiang B. Comorbidities as predictors of inpatient deaths after hip fracture in Chinese elderly patients: analysis of hospital records. Lancet. 2017 Dec;390(Suppl 4):S78. https://doi.org/10.1016/S0140-6736(17)33216-6
32. González Marcos E, González García E, Rodríguez Fernández P, Sánchez González E, González Bernal JJ, González Santos J, et al. Determinants of higher mortality at six months in patients with hip fracture: a retrospective study. J Clin Med. 2022 Apr 29;11(9):2514. https://doi.org/10.3390/jcm11092514.
33. Wong RMY, Zu Y, Chau WW, Tso CY, Liu WH, Ng RWK, et al. High Charlson Comorbidity Index score is associated with early fracture related complications for internal fixation of neck of femur fractures. Sci Rep. 2022 Mar 19;12:4749. https://doi.org/10.1038/s41598-022-08855-0
34. da Casa C, Pablos Hernández C, González Ramírez A, Blanco JF. Functional status geriatric scores: single handed tools for 30 day mortality risk after hip fracture. Clin Interv Aging. 2021 Apr 28;16:721–29. https://doi.org/10.2147/CIA.S302620
35. Guo Z, Zhao F, Wang Y, Wang X. Intensive Care Unit resource utilization after hip fracture surgery in elderly patients: risk factor identification and risk stratification. Orthopedics. 2020 May 1;43(3):e159–65.https://doi.org/10.3928/01477447-20200129-02
36. Budhia S, Mikyas Y, Tang M, Badamgarav E. Osteoporotic fractures: a systematic review of U.S. healthcare costs and resource utilization. Pharmacoeconomics. 2012 Feb;30(2):147–70. https://doi.org/10.2165/11596880-000000000-00000
37. Robbins JA, Buzkova P, Barzilay JI, Cauley JA, Fink HA, Carbone LD, Chen Z, Stein PK, Elam R, Sheets K, Mukamal KJ. Mortality following hip fracture in older adults with and without coronary heart disease. Am J Med. 2023 Aug;136(8):789 95.e2. https://doi.org/10.1016/j.amjmed.2023.03.036
38. Panula J, Pihlajamäki H, Mattila VM, Jaatinen P, Vahlberg T, Aarnio P, Kivelä SL. Mortality and cause of death in hip fracture patients aged 65 or older: a population-based study. BMC Musculoskelet Disord. 2011 May 20;12:105. https://doi.org/10.1186/1471-2474-12-105
39. García Gómez A, Leal Capdesuñer O, Martínez Llano Y, Sanabria Blanco OL, Coca Machado JL. Morbi mortalidad del paciente adulto mayor en una sala de cuidados intensivos. Rev Cubana Med Mil. 2015 Oct Dec;44(4)
40. Kim BH, Lee S, Yoo B, Lee WY, Lim Y, Kim MC, Yon JH, Kim KM. Risk factors associated with outcomes of hip fracture surgery in elderly patients. Korean J Anesthesiol. 2015 Dec;68(6):561–7. https://doi.org/10.4097/kjae.2015.68.6.561
41. Trejo G, Zia A, Caronia C, Arrillaga A, Cuellar J, Pujol TA, et al. Retrospective analysis of risk factors in geriatric hip fracture patients predictive of surgical intensive care unit admission. Cureus. 2024 May 24;16(5):e60993. https://doi.org/10.7759/cureus.60993
42. Fasanya C, Lee JJ, Caronia CG, Rothburd L, Japhe T, Hahn YH, Reci D, Eckardt P. The impact of screening for perioperative ICU admission in geriatric hip fracture patients: a retrospective analysis. Cureus. 2023 Nov 22;15(11):e49234. https://doi.org/10.7759/cureus.49234
43. Leal J, Gray AM, Prieto-Alhambra D, Arden NK, Cooper C, Javaid MK, Judge A; REFReSH study group. Impact of hip fracture on hospital care costs: a population-based study. Osteoporos Int. 2016 Feb;27(2):549–58. https://doi.org/10.1007/s00198-015-3277-9
44. Woolf AD, Akesson K. Preventing fractures in elderly people. BMJ. 2003 Jul 12;327(7406):89–95. https://doi.org/10.1136/bmj.327.7406.89
45. Epidat: programa para análisis epidemiológico de datos. Versión 4.2, julio 2016. Consellería de Sanidade, Xunta de Galicia, España; Organización Panamericana de la salud (OPS-OMS); Universidad CES, Colombia.
46. StataCorp. Stata Statistical Software: Release 17. College Station, TX: StataCorp LLC; 2021.
47. Ministerio de Salud y Protección Social. Resolución número 8430 de 1993: por la cual se establecen las normas científicas, técnicas y administrativas para la investigación en salud. Bogotá: Ministerio de Salud; 1993.
48. Sun M, Chen W M, Wu S Y, Zhang J. Long term mortality impact of postoperative hyperactive delirium in older hip fracture surgery patients. BMC Geriatr. 2025 Mar;25:180. https://doi.org/10.1186/s12877-025-05817-9
49. Guzon Illescas O, Perez Fernandez E, Crespí Villarias N, Quirós Donate FJ, Peña M, Alonso Blas C, et al. Mortality after osteoporotic hip fracture: incidence, trends, and associated factors. J Orthop Surg Res. 2019 Jul 17;14:203. https://doi.org/10.1186/s13018-019-1226-6
50. Crimmins EM, Shim H, Zhang YS, Kim JK. Differences between men and women in mortality and the health dimensions of the morbidity process. Clin Chem. 2019 Jan;65(1):135–45. https://doi.org/10.1373/clinchem.2018.288332
51. Orwig D, Hochberg MC, Gruber Baldini AL, Resnick B, Miller RR, Hicks GE, et al. Examining differences in recovery outcomes between male and female hip fracture patients: design and baseline results of a prospective cohort study from the Baltimore Hip Studies. J Frailty Aging. 2018 Mar;7(3):162–9. https://doi.org/10.14283/jfa.2018.15
52. Pugely AJ, Martin CT, Gao Y, Klocke NF, Callaghan JJ, Marsh JL. A risk calculator for short term morbidity and mortality after hip fracture surgery. J Orthop Trauma. 2014 Jan;28(1):63–9. https://doi.org/10.1097/BOT.0b013e3182a22744.
53. Zhang H, Ma L, Yu X. Risk factors of postoperative complications and in hospital mortality after hip fracture among patients older than 80 years old: a retrospective study. BMC Surg. 2025;25:122. https://doi.org/10.1186/s12893-025-02862-4
54. Ju J, Zhang P, Wang Y, Kou Y, Fu Z, Jiang B, et al. A clinical nomogram predicting unplanned intensive care unit admission after hip fracture surgery. Surgery. 2021 Mar;170(3):291–7. https://doi.org/10.1016/j.surg.2021.01.009
55. Bernate JD, López AM, Rojas Liévano J, Pesantez R, Patiño A, Sanint V, et al. Preoperative anticoagulation and its impact on surgical timing and postoperative outcomes in hip fracture surgery: a retrospective study at an Orthogeriatrics Clinical Care Center in Colombia. Eur J Orthop Surg Traumatol. 2025;35:170. https://doi.org/10.1007/s00590-025-04286-5
56. Hasan O, Barkat R, Rabbani A, Rabbani U, Mahmood F, Noordin S. Charlson comorbidity index predicts postoperative complications in surgically treated hip fracture patients in a tertiary care hospital: retrospective cohort of 1045 patients. Int J Surg. 2020;82:147–53. https://doi.org/10.1016/j.ijsu.2020.08.017
57. Al Husinat L, Azzam S, Al Sharie S, Al Hseinat L, Araydah M, Al Modanat Z, et al. Impact of the American Society of Anesthesiologists (ASA) classification on hip fracture surgery outcomes: insights from a retrospective analysis. BMC Anesthesiol. 2024;24:271. https://doi.org/10.1186/s12871-024-02660-0
58. Chiavarini M, Ricciotti GM, Genga A, Faggi MI, Rinaldi A, Toscano OD, et al. Malnutrition-related health outcomes in older adults with hip fractures: a systematic review and meta-analysis. Nutrients. 2024 Jul;16(7):1069. https://doi.org/10.3390/nu16071069
59. Praetorius K, Madsen CM, Abrahamsen B, Jørgensen HL, Lauritzen JB, Laulund ASB. Low levels of hemoglobin at admission are associated with increased 30 day mortality in patients with hip fracture. Geriatr Orthop Surg Rehabil. 2016;7:115–20. https://doi.org/10.1177/2151458516647989
60. Tung Y C, Hsu Y H, Chang G M. The effect of anesthetic type on outcomes of hip fracture surgery. Medicine (Baltimore). 2016 Jun;95(22):e3296. https://doi.org/10.1097/MD.0000000000003296
dc.rights.coar.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.rights.local.spa.fl_str_mv Acceso abierto
dc.rights.accessrights.none.fl_str_mv https://purl.org/coar/access_right/c_abf2
rights_invalid_str_mv Acceso abierto
https://purl.org/coar/access_right/c_abf2
http://purl.org/coar/access_right/c_abf2
dc.format.mimetype.none.fl_str_mv application/pdf
dc.publisher.program.spa.fl_str_mv Especialización en Medicina Interna
dc.publisher.grantor.spa.fl_str_mv Universidad El Bosque
dc.publisher.faculty.spa.fl_str_mv Facultad de Medicina
institution Universidad El Bosque
bitstream.url.fl_str_mv https://pruebas-update-repositorio-unbosque.cloudbiteca.com/bitstreams/e1c8c59c-c40b-49ee-9c44-f9526efd2cb8/download
https://pruebas-update-repositorio-unbosque.cloudbiteca.com/bitstreams/7f54385d-3fc2-4c10-89fd-2cf5b38f0af4/download
https://pruebas-update-repositorio-unbosque.cloudbiteca.com/bitstreams/bfb8dab4-cf18-4a1a-b4c4-56a657cfd440/download
https://pruebas-update-repositorio-unbosque.cloudbiteca.com/bitstreams/bfac391c-c9ae-4dd8-8642-b65052b2dc99/download
https://pruebas-update-repositorio-unbosque.cloudbiteca.com/bitstreams/02b0b846-cb97-4c74-bdfc-944a1718b91b/download
https://pruebas-update-repositorio-unbosque.cloudbiteca.com/bitstreams/ca406e2c-1f00-4226-9664-ffd08986be2a/download
bitstream.checksum.fl_str_mv 17cc15b951e7cc6b3728a574117320f9
12e98394e825af32aa60485a7c036abd
54e69dbe5d89cffeeb853784674d8eae
130247e6ef111722ecb25f1f375d735a
c56e58eff7734621a27795f97b4f89b2
b9b56897950004cfb4131ee4c0fe27c7
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
MD5
MD5
MD5
MD5
repository.name.fl_str_mv Repositorio Institucional Universidad El Bosque
repository.mail.fl_str_mv bibliotecas@biteca.com
_version_ 1849967290449133568
spelling Mendoza Obirne, MarioLizarazo Jimenez, Maria JoseCampaña Perilla, Laura AndreaBernate, Juan DavidSanint Castro, ValentinaPatiño Patiño, Aldo FernandoLizarazo Jimenez, Maria [0000-0002-2111-4440]2025-07-28T16:31:07Z2025-07-28T16:31:07Z2025-07https://hdl.handle.net/20.500.12495/15327instname:Universidad El Bosquereponame:Repositorio Institucional Universidad El Bosquerepourl:https://repositorio.unbosque.edu.coINTRODUCCIÓN Las fracturas de cadera representan un importante problema de salud pública, asociado con altos costos hospitalarios y un impacto significativo en la calidad de vida relacionada con la salud reportada por los pacientes. En los adultos mayores, también contribuyen a una mayor morbilidad y mortalidad, siendo más frecuentes en esta población debido a la disminución de la densidad mineral ósea, cambios en las propiedades del hueso, debilidad muscular y mayor riesgo de caídas. Aunque estudios previos han identificado asociaciones entre factores clínicos o funcionales y el ingreso a la unidad de cuidados intensivos (UCI) en adultos mayores con fractura de cadera, estos factores han sido evaluados frecuentemente de forma aislada y sin considerar interacciones entre múltiples dominios. OBJETIVO Evaluar de forma integral los factores sociodemográficos, clínicos, paraclínicos, funcionales y quirúrgicos asociados con el ingreso a la unidad de cuidados intensivos (UCI). MATERIALES Y MÉTODOS Se realizó un estudio de cohortes retrospectivo con componente analítico. La población fue descrita mediante frecuencias, porcentajes, medias con desviaciones estándar o medianas con rangos intercuartílicos, según la distribución evaluada con la prueba de Shapiro-Wilk. Las asociaciones entre las variables independientes y el ingreso a UCI se exploraron mediante análisis bivariado (prueba t de Student, U de Mann–Whitney, chi-cuadrado o regresión logística binaria, según el tipo de variable). Las variables significativas se incluyeron en modelos multivariados luego de verificar la ausencia de multicolinealidad. Se construyeron modelos de regresión logística agrupados por dominios (sociodemográfico, comorbilidades, índices clínicos y paraclínicos), además de un modelo final robusto que integró las variables más relevantes. Se estimaron razones de odds (OR) con intervalos de confianza (IC) del 95%. RESULTADOS Entre los 431 pacientes incluidos, el 16.9% requirió ingreso a la unidad de cuidados intensivos (UCI). En el modelo multivariado integral, los factores clínicos y funcionales más fuertemente asociados con el ingreso a UCI fueron la insuficiencia cardiaca (OR: 10.63; IC 95%: 3.25–34.79), el delirium preoperatorio evaluado mediante la escala Confusion Assessment Method (CAM) (OR: 4.37; IC 95%: 1.57–12.19), el antecedente de caídas previas (OR: 1.54; IC 95%: 1.03–2.33), y el número de unidades de glóbulos rojos transfundidas (OR: 1.66; IC 95%: 1.28–2.16). CONCLUSIONES El ingreso a la unidad de cuidados intensivos (UCI) después de una cirugía por fractura de cadera en adultos mayores estuvo asociado principalmente por la vulnerabilidad clínica y funcional. Incorporar estos factores en la evaluación preoperatoria podría mejorar la estratificación del riesgo y la atención perioperatoria en contextos ortogeriátricos.Fundación Santa Fe de BogotáEspecialista en Medicina InternaEspecializaciónINTRODUCTION Hip fractures represent a significant public health issue, associated with high hospital costs and substantial impact on patient-reported health-related quality of life. In older adults, they also contribute to increased morbidity and mortality, being more common in this population due to decreased bone mineral density, changes in bone properties, muscle weakness, and higher risk of falls. Although previous studies have identified associations between clinical or functional factors and postoperative ICU admission in older adults with hip fractures, these have often been examined separately and without considering interactions across multiple domains OBJECTIVE This study aimed to comprehensively assess sociodemographic, clinical, laboratory parameters, functional, and surgical characteristics associated with intensive care unit (ICU) admission. MATERIALS AND METHODS A retrospective cohort study with an analytical component was conducted. The population was described using frequencies, percentages, means with standard deviations, or medians with interquartile ranges, according to the distribution assessed using the Shapiro-Wilk test. Associations between independent variables and ICU admission were explored using bivariate analysis (Student’s t-test, Mann–Whitney U test, chi-square test, or binary logistic regression, depending on the variable type). Significant variables were included in multivariate models after verifying the absence of multicollinearity. Logistic regression models were grouped by domains (sociodemographic, comorbidities, clinical and paraclinical indices), and a final robust model was constructed integrating the most significant variables. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. RESULTS Among the 431 patients included, 16.9% required admission to the intensive care unit (ICU). In the comprehensive model, the most important clinical and functional factors associated with ICU admission were heart failure (OR: 10.63; 95% CI: 3.25–34.79), preoperative delirium assessed using the Confusion Assessment Method (CAM) (OR: 4.37; 95% CI: 1.57–12.19), history of prior falls (OR: 1.54; 95% CI: 1.03–2.33), and the number of transfused red blood cell (RBC) units (OR: 1.66; 95% CI: 1.28–2.16) CONCLUSIONS ICU admission after hip fracture surgery in older adults was primarily driven by clinical and functional vulnerability. Incorporating these factors into preoperative assessments may improve risk stratification and perioperative care in orthogeriatric settings.application/pdfFractura de caderaUnidad de cuidados intensivosFactores asociadosGeriatríaOrtogeriatríaHip fractureIntensive care unitAssociated factorsGeriatricsOrthogeriatricsWB 115Factores relacionados con la necesidad de soporte vasoactivo o ventilatorio en el postoperatorio de fractura de cadera en el Hospital Fundación Santa Fe de Bogotá entre los años 2018 a 2022Factors Associated with the Need for Vasopressor or Ventilatory Support Following Hip Fracture Surgery at Fundación Santa Fe de Bogotá (2018–2022)Especialización en Medicina InternaUniversidad El BosqueFacultad de MedicinaTesis/Trabajo de grado - Monografía - Especializaciónhttps://purl.org/coar/resource_type/c_7a1fhttp://purl.org/coar/resource_type/c_7a1finfo:eu-repo/semantics/bachelorThesishttps://purl.org/coar/version/c_ab4af688f83e57aa1. Wu A M, Bisignano C, James SL, Abady GG, Abedi A, Abu Gharbieh E, et al. Global, regional, and national burden of bone fractures in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet Healthy Longev. 2021;2(9):e580–92. https://doi.org/10.1016/S2666-7568(21)00102-02. Deutschbein J, Lindner T, Möckel M, Pigorsch M, Gilles G, Stöckle U, et al. Health-related quality of life and associated factors after hip fracture. Results from a six-month prospective cohort study. PeerJ. 2023;11:e14671. https://doi.org/10.7717/peerj.146713. Weycker D, Li X, Barron R, Bornheimer R, Chandler D. Hospitalizations for osteoporosis-related fractures: economic costs and clinical outcomes. Bone Rep. 2016;5:186–91. https://doi.org/10.1016/j.bonr.2016.07.0054. Dubljanin‑Raspopović E, Marković‑Denić L, Marinković J, Nedeljković U, Bumbaširević M, et al. Does early functional outcome predict 1‑year mortality in elderly patients with hip fracture? Clin Orthop Relat Res. 2013 Aug;471(8):2703–10. https://doi.org/10.1007/s11999-013-2955-15. Colón Emeric CS, Kuchibhatla M, Pieper C, et al. The contribution of hip fracture to risk of subsequent fractures: data from two longitudinal studies. Osteoporos Int. 2003 Nov;14(11):879–83. https://doi.org/10.1007/s00198-003-1460-x6. Marks R, Allegrante JP, MacKenzie CR, Lane JM. Hip fractures among the elderly: causes, consequences and control. Ageing Res Rev. 2003 Jan;2(1):57–93. https://doi.org/10.1016/S1568-1637(02)00045-47. Birge SJ. Osteoporosis and hip fracture. Clin Geriatr Med. 1993 Feb;9(1):69-86. PMID: 8443741.8. Yang Y, Komisar V, Shishov N, Lo B, Korall AMB, Feldman F, et al. The effect of fall biomechanics on risk for hip fracture in older adults: a cohort study of video captured falls in long term care. J Bone Miner Res. 2020 Oct;35(10):1914–22. https://doi.org/10.1002/jbmr.40489. Lloyd R, Baker G, MacDonald J, Thompson NW. Co-morbidities in Patients with a Hip Fracture. Ulster Med J. 2019 Sep;88(3):162–6. Epub 2019 Oct 11. PMID: 3161985010. Roche JJW, Wenn RT, Sahota O, Moran CG. Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study. BMJ. 2005 Dec 10;331(7529):1374. doi: 10.1136/bmj.38643.663843.55.11. Gillespie WJ. Extracts from "clinical evidence": hip fracture. BMJ. 2001 Apr 21;322(7292):968–75. https://doi.org/10.1136/bmj.322.7292.968.12. Veronese N, Maggi S. Epidemiology and social costs of hip fracture. Injury. 2018 Aug;49(8):1458–60. https://doi.org/10.1016/j.injury.2018.04.01513. Pech-Ciau BA, Lima-Martínez EA, Espinosa-Cruz GA, Pacho-Aguilar CR, Huchim-Lara O, Alejos-Gómez RA. Fractura de cadera en el adulto mayor: epidemiología y costos de la atención. Acta Ortop Mex. 2021;35(4):341–7. https://doi.org/10.35366/10331414. Cooper C, Campion G, Melton LJ. Hip fractures in the elderly: a world-wide projection. Osteoporos Int. 1992 Nov;2(6):285–9. https://doi.org/10.1007/BF0162318415. Alswat KA. Gender disparities in osteoporosis. J Clin Med Res. 2017 May;9(5):382–7. https://doi.org/10.14740/jocmr2970w16. Kanis JA, Odén A, McCloskey EV, Johansson H, Wahl DA, Cooper C; IOF Working Group on Epidemiology and Quality of Life. A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int. 2012 Sep;23(9):2239–56. https://doi.org/10.1007/s00198-012-1964-317. Neer RM. The evolutionary significance of vitamin D, skin pigment, and ultraviolet light. Am J Phys Anthropol. 1975 Nov;43(3):409–16. https://doi.org/10.1002/ajpa.133043032218. Kazley JM, Banerjee S, Abousayed MM, Rosenbaum AJ. Classifications in brief: Garden classification of femoral neck fractures. Clin Orthop Relat Res. 2018 Feb;476(2):441–5. https://doi.org/10.1007/s11999.000000000000006619. Meinberg EG, Agel J, Roberts CS, Karam MD, Kellam JF. Fracture and dislocation classification compendium–2018. J Orthop Trauma. 2018 Jan;32 Suppl 1:S1–S170. https://doi.org/10.1097/BOT.000000000000106320. Masionis P, Uvarovas V, Mazarevičius G, Popov K, Venckus Š, Baužys K, Porvaneckas N. The reliability of a Garden, AO and simple II stage classifications for intracapsular hip fractures. Orthop Traumatol Surg Res. 2019 Feb;105(1):29–33. https://doi.org/10.1016/j.otsr.2018.11.007.21. Lewis SR, Macey R, Gill JR, Parker MJ, Griffin XL. Cephalomedullary nails versus extramedullary implants for extracapsular hip fractures in older adults. Cochrane Database Syst Rev. 2022 Jan 14;2022(1):CD000093. https://doi.org/10.1002/14651858.CD000093.pub622. Varacallo MA, Luo TD, Johanson NA. Total hip arthroplasty techniques [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan– [updated 2023 Aug 4; cited 2025 Jul 25]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507864/23. Kannus P, Parkkari J, Sievänen H, Heinonen A, Vuori I, Järvinen M. Epidemiology of hip fractures. Bone. 1996 Jan;18(1 Suppl):57S–63S. doi: 10.1016/8756 3282(95)00381 924. Palm H. Hip fracture: the choice of surgery. In: Falaschi P, Marsh D, editors. Orthogeriatrics: The Management of Older Patients with Fragility Fractures. 2nd ed. Cham (CH): Springer; 2021. p. 125–41. https://doi.org/10.1007/978-3-030-48126-1_9.25. Klestil T, Röder C, Stotter C, Winkler B, Nehrer S, Lutz M, et al. Impact of timing of surgery in elderly hip fracture patients: a systematic review and meta analysis. Sci Rep. 2018 Sep 17;8(1):13933. https://doi.org/10.1038/s41598-018-32098-726. Schep NWL, Heintjes RJ, Martens EP, van Dortmont LMC, van Vugt AB. Retrospective analysis of factors influencing the operative result after percutaneous osteosynthesis of intracapsular femoral neck fractures. Injury. 2004 Oct;35(10):1003–9. https://doi.org/10.1016/j.injury.2003.07.001.27. Parker MJ, Gurusamy KS. Internal fixation implants for intracapsular hip fractures in adults. Cochrane Database Syst Rev. 2001;(4):CD001467. https://doi.org/10.1002/14651858.CD001467.28. Nonne D, Sanna F, Bardelli A, Milano P, Rivera F. Use of a dual mobility cup to prevent hip early arthroplasty dislocation in patients at high falls risk. Injury. 2019 Aug;50(Suppl 4):S26–9. https://doi.org/10.1016/j.injury.2019.01.022.29. Pincus D, Ravi B, Wasserstein D, Huang A, Paterson JM, Nathens AB, et al. Association between wait time and 30 day mortality in adults undergoing hip fracture surgery. JAMA. 2017 Nov 28;318(20):1994–2003. https://doi.org/10.1001/jama.2017.17606.30. Lin DY, Woodman R, Oberai T, Brown B, Morrison C, Kroon H, et al. Association of anesthesia and analgesia with long term mortality after hip fracture surgery: an analysis of the Australian and New Zealand Hip Fracture Registry. Reg Anesth Pain Med. 2023 Jan;48(1):14–21. https://doi.org/10.1136/rapm-2022-10355031. Ma M, Lu H, Fu Z, Zhang P, Jiang B. Comorbidities as predictors of inpatient deaths after hip fracture in Chinese elderly patients: analysis of hospital records. Lancet. 2017 Dec;390(Suppl 4):S78. https://doi.org/10.1016/S0140-6736(17)33216-632. González Marcos E, González García E, Rodríguez Fernández P, Sánchez González E, González Bernal JJ, González Santos J, et al. Determinants of higher mortality at six months in patients with hip fracture: a retrospective study. J Clin Med. 2022 Apr 29;11(9):2514. https://doi.org/10.3390/jcm11092514.33. Wong RMY, Zu Y, Chau WW, Tso CY, Liu WH, Ng RWK, et al. High Charlson Comorbidity Index score is associated with early fracture related complications for internal fixation of neck of femur fractures. Sci Rep. 2022 Mar 19;12:4749. https://doi.org/10.1038/s41598-022-08855-034. da Casa C, Pablos Hernández C, González Ramírez A, Blanco JF. Functional status geriatric scores: single handed tools for 30 day mortality risk after hip fracture. Clin Interv Aging. 2021 Apr 28;16:721–29. https://doi.org/10.2147/CIA.S30262035. Guo Z, Zhao F, Wang Y, Wang X. Intensive Care Unit resource utilization after hip fracture surgery in elderly patients: risk factor identification and risk stratification. Orthopedics. 2020 May 1;43(3):e159–65.https://doi.org/10.3928/01477447-20200129-0236. Budhia S, Mikyas Y, Tang M, Badamgarav E. Osteoporotic fractures: a systematic review of U.S. healthcare costs and resource utilization. Pharmacoeconomics. 2012 Feb;30(2):147–70. https://doi.org/10.2165/11596880-000000000-0000037. Robbins JA, Buzkova P, Barzilay JI, Cauley JA, Fink HA, Carbone LD, Chen Z, Stein PK, Elam R, Sheets K, Mukamal KJ. Mortality following hip fracture in older adults with and without coronary heart disease. Am J Med. 2023 Aug;136(8):789 95.e2. https://doi.org/10.1016/j.amjmed.2023.03.03638. Panula J, Pihlajamäki H, Mattila VM, Jaatinen P, Vahlberg T, Aarnio P, Kivelä SL. Mortality and cause of death in hip fracture patients aged 65 or older: a population-based study. BMC Musculoskelet Disord. 2011 May 20;12:105. https://doi.org/10.1186/1471-2474-12-10539. García Gómez A, Leal Capdesuñer O, Martínez Llano Y, Sanabria Blanco OL, Coca Machado JL. Morbi mortalidad del paciente adulto mayor en una sala de cuidados intensivos. Rev Cubana Med Mil. 2015 Oct Dec;44(4)40. Kim BH, Lee S, Yoo B, Lee WY, Lim Y, Kim MC, Yon JH, Kim KM. Risk factors associated with outcomes of hip fracture surgery in elderly patients. Korean J Anesthesiol. 2015 Dec;68(6):561–7. https://doi.org/10.4097/kjae.2015.68.6.56141. Trejo G, Zia A, Caronia C, Arrillaga A, Cuellar J, Pujol TA, et al. Retrospective analysis of risk factors in geriatric hip fracture patients predictive of surgical intensive care unit admission. Cureus. 2024 May 24;16(5):e60993. https://doi.org/10.7759/cureus.6099342. Fasanya C, Lee JJ, Caronia CG, Rothburd L, Japhe T, Hahn YH, Reci D, Eckardt P. The impact of screening for perioperative ICU admission in geriatric hip fracture patients: a retrospective analysis. Cureus. 2023 Nov 22;15(11):e49234. https://doi.org/10.7759/cureus.4923443. Leal J, Gray AM, Prieto-Alhambra D, Arden NK, Cooper C, Javaid MK, Judge A; REFReSH study group. Impact of hip fracture on hospital care costs: a population-based study. Osteoporos Int. 2016 Feb;27(2):549–58. https://doi.org/10.1007/s00198-015-3277-944. Woolf AD, Akesson K. Preventing fractures in elderly people. BMJ. 2003 Jul 12;327(7406):89–95. https://doi.org/10.1136/bmj.327.7406.8945. Epidat: programa para análisis epidemiológico de datos. Versión 4.2, julio 2016. Consellería de Sanidade, Xunta de Galicia, España; Organización Panamericana de la salud (OPS-OMS); Universidad CES, Colombia.46. StataCorp. Stata Statistical Software: Release 17. College Station, TX: StataCorp LLC; 2021.47. Ministerio de Salud y Protección Social. Resolución número 8430 de 1993: por la cual se establecen las normas científicas, técnicas y administrativas para la investigación en salud. Bogotá: Ministerio de Salud; 1993.48. Sun M, Chen W M, Wu S Y, Zhang J. Long term mortality impact of postoperative hyperactive delirium in older hip fracture surgery patients. BMC Geriatr. 2025 Mar;25:180. https://doi.org/10.1186/s12877-025-05817-949. Guzon Illescas O, Perez Fernandez E, Crespí Villarias N, Quirós Donate FJ, Peña M, Alonso Blas C, et al. Mortality after osteoporotic hip fracture: incidence, trends, and associated factors. J Orthop Surg Res. 2019 Jul 17;14:203. https://doi.org/10.1186/s13018-019-1226-650. Crimmins EM, Shim H, Zhang YS, Kim JK. Differences between men and women in mortality and the health dimensions of the morbidity process. Clin Chem. 2019 Jan;65(1):135–45. https://doi.org/10.1373/clinchem.2018.28833251. Orwig D, Hochberg MC, Gruber Baldini AL, Resnick B, Miller RR, Hicks GE, et al. Examining differences in recovery outcomes between male and female hip fracture patients: design and baseline results of a prospective cohort study from the Baltimore Hip Studies. J Frailty Aging. 2018 Mar;7(3):162–9. https://doi.org/10.14283/jfa.2018.1552. Pugely AJ, Martin CT, Gao Y, Klocke NF, Callaghan JJ, Marsh JL. A risk calculator for short term morbidity and mortality after hip fracture surgery. J Orthop Trauma. 2014 Jan;28(1):63–9. https://doi.org/10.1097/BOT.0b013e3182a22744.53. Zhang H, Ma L, Yu X. Risk factors of postoperative complications and in hospital mortality after hip fracture among patients older than 80 years old: a retrospective study. BMC Surg. 2025;25:122. https://doi.org/10.1186/s12893-025-02862-454. Ju J, Zhang P, Wang Y, Kou Y, Fu Z, Jiang B, et al. A clinical nomogram predicting unplanned intensive care unit admission after hip fracture surgery. Surgery. 2021 Mar;170(3):291–7. https://doi.org/10.1016/j.surg.2021.01.00955. Bernate JD, López AM, Rojas Liévano J, Pesantez R, Patiño A, Sanint V, et al. Preoperative anticoagulation and its impact on surgical timing and postoperative outcomes in hip fracture surgery: a retrospective study at an Orthogeriatrics Clinical Care Center in Colombia. Eur J Orthop Surg Traumatol. 2025;35:170. https://doi.org/10.1007/s00590-025-04286-556. Hasan O, Barkat R, Rabbani A, Rabbani U, Mahmood F, Noordin S. Charlson comorbidity index predicts postoperative complications in surgically treated hip fracture patients in a tertiary care hospital: retrospective cohort of 1045 patients. Int J Surg. 2020;82:147–53. https://doi.org/10.1016/j.ijsu.2020.08.01757. Al Husinat L, Azzam S, Al Sharie S, Al Hseinat L, Araydah M, Al Modanat Z, et al. Impact of the American Society of Anesthesiologists (ASA) classification on hip fracture surgery outcomes: insights from a retrospective analysis. BMC Anesthesiol. 2024;24:271. https://doi.org/10.1186/s12871-024-02660-058. Chiavarini M, Ricciotti GM, Genga A, Faggi MI, Rinaldi A, Toscano OD, et al. Malnutrition-related health outcomes in older adults with hip fractures: a systematic review and meta-analysis. Nutrients. 2024 Jul;16(7):1069. https://doi.org/10.3390/nu1607106959. Praetorius K, Madsen CM, Abrahamsen B, Jørgensen HL, Lauritzen JB, Laulund ASB. Low levels of hemoglobin at admission are associated with increased 30 day mortality in patients with hip fracture. Geriatr Orthop Surg Rehabil. 2016;7:115–20. https://doi.org/10.1177/215145851664798960. Tung Y C, Hsu Y H, Chang G M. The effect of anesthetic type on outcomes of hip fracture surgery. Medicine (Baltimore). 2016 Jun;95(22):e3296. https://doi.org/10.1097/MD.0000000000003296Acceso abiertohttps://purl.org/coar/access_right/c_abf2http://purl.org/coar/access_right/c_abf2spaLICENSElicense.txtlicense.txttext/plain; charset=utf-82000https://pruebas-update-repositorio-unbosque.cloudbiteca.com/bitstreams/e1c8c59c-c40b-49ee-9c44-f9526efd2cb8/download17cc15b951e7cc6b3728a574117320f9MD53falseAnonymousREADCarta de autorizacion.pdfapplication/pdf31257891https://pruebas-update-repositorio-unbosque.cloudbiteca.com/bitstreams/7f54385d-3fc2-4c10-89fd-2cf5b38f0af4/download12e98394e825af32aa60485a7c036abdMD55falseBiblioteca - (Publicadores)READAnexo 1 Acta de aprobacion.pdfapplication/pdf468602https://pruebas-update-repositorio-unbosque.cloudbiteca.com/bitstreams/bfb8dab4-cf18-4a1a-b4c4-56a657cfd440/download54e69dbe5d89cffeeb853784674d8eaeMD58falseBiblioteca - (Publicadores)READORIGINALTrabajo de grado.pdfTrabajo de grado.pdfapplication/pdf2051297https://pruebas-update-repositorio-unbosque.cloudbiteca.com/bitstreams/bfac391c-c9ae-4dd8-8642-b65052b2dc99/download130247e6ef111722ecb25f1f375d735aMD54trueAnonymousREAD2026-07-27TEXTTrabajo de grado.pdf.txtTrabajo de grado.pdf.txtExtracted texttext/plain101584https://pruebas-update-repositorio-unbosque.cloudbiteca.com/bitstreams/02b0b846-cb97-4c74-bdfc-944a1718b91b/downloadc56e58eff7734621a27795f97b4f89b2MD56falseAnonymousREAD2026-07-27THUMBNAILTrabajo de grado.pdf.jpgTrabajo de grado.pdf.jpgGenerated Thumbnailimage/jpeg3131https://pruebas-update-repositorio-unbosque.cloudbiteca.com/bitstreams/ca406e2c-1f00-4226-9664-ffd08986be2a/downloadb9b56897950004cfb4131ee4c0fe27c7MD57falseAnonymousREAD2026-07-2720.500.12495/15327oai:pruebas-update-repositorio-unbosque.cloudbiteca.com:20.500.12495/153272025-08-05T14:05:59.610Zembargo2026-07-27https://pruebas-update-repositorio-unbosque.cloudbiteca.comRepositorio Institucional Universidad El Bosquebibliotecas@biteca.comTGljZW5jaWEgZGUgRGlzdHJpYnVjacOzbiBObyBFeGNsdXNpdmEKClBhcmEgcXVlIGVsIFJlcG9zaXRvcmlvIGRlIGxhIFVuaXZlcnNpZGFkIEVsIEJvc3F1ZSBhIHB1ZWRhIHJlcHJvZHVjaXIgeSBjb211bmljYXIgcMO6YmxpY2FtZW50ZSBzdSBkb2N1bWVudG8gZXMgbmVjZXNhcmlvIGxhIGFjZXB0YWNpw7NuIGRlIGxvcyBzaWd1aWVudGVzIHTDqXJtaW5vcy4gUG9yIGZhdm9yLCBsZWEgbGFzIHNpZ3VpZW50ZXMgY29uZGljaW9uZXMgZGUgbGljZW5jaWE6CgoxLiBBY2VwdGFuZG8gZXN0YSBsaWNlbmNpYSwgdXN0ZWQgKGVsIGF1dG9yL2VzIG8gZWwgcHJvcGlldGFyaW8vcyBkZSBsb3MgZGVyZWNob3MgZGUgYXV0b3IpIGdhcmFudGl6YSBhIGxhIFVuaXZlcnNpZGFkIEVsIEJvc3F1ZSBlbCBkZXJlY2hvIG5vIGV4Y2x1c2l2byBkZSBhcmNoaXZhciwgcmVwcm9kdWNpciwgY29udmVydGlyIChjb21vIHNlIGRlZmluZSBtw6FzIGFiYWpvKSwgY29tdW5pY2FyIHkvbyBkaXN0cmlidWlyIHN1IGRvY3VtZW50byBtdW5kaWFsbWVudGUgZW4gZm9ybWF0byBlbGVjdHLDs25pY28uCgoyLiBUYW1iacOpbiBlc3TDoSBkZSBhY3VlcmRvIGNvbiBxdWUgbGEgVW5pdmVyc2lkYWQgRWwgQm9zcXVlIHB1ZWRhIGNvbnNlcnZhciBtw6FzIGRlIHVuYSBjb3BpYSBkZSBlc3RlIGRvY3VtZW50byB5LCBzaW4gYWx0ZXJhciBzdSBjb250ZW5pZG8sIGNvbnZlcnRpcmxvIGEgY3VhbHF1aWVyIGZvcm1hdG8gZGUgZmljaGVybywgbWVkaW8gbyBzb3BvcnRlLCBwYXJhIHByb3DDs3NpdG9zIGRlIHNlZ3VyaWRhZCwgcHJlc2VydmFjacOzbiB5IGFjY2Vzby4KCjMuIERlY2xhcmEgcXVlIGVsIGRvY3VtZW50byBlcyB1biB0cmFiYWpvIG9yaWdpbmFsIHN1eW8geS9vIHF1ZSB0aWVuZSBlbCBkZXJlY2hvIHBhcmEgb3RvcmdhciBsb3MgZGVyZWNob3MgY29udGVuaWRvcyBlbiBlc3RhIGxpY2VuY2lhLiBUYW1iacOpbiBkZWNsYXJhIHF1ZSBzdSBkb2N1bWVudG8gbm8gaW5mcmluZ2UsIGVuIHRhbnRvIGVuIGN1YW50byBsZSBzZWEgcG9zaWJsZSBzYWJlciwgbG9zIGRlcmVjaG9zIGRlIGF1dG9yIGRlIG5pbmd1bmEgb3RyYSBwZXJzb25hIG8gZW50aWRhZC4KCjQuIFNpIGVsIGRvY3VtZW50byBjb250aWVuZSBtYXRlcmlhbGVzIGRlIGxvcyBjdWFsZXMgbm8gdGllbmUgbG9zIGRlcmVjaG9zIGRlIGF1dG9yLCBkZWNsYXJhIHF1ZSBoYSBvYnRlbmlkbyBlbCBwZXJtaXNvIHNpbiByZXN0cmljY2nDs24gZGVsIHByb3BpZXRhcmlvIGRlIGxvcyBkZXJlY2hvcyBkZSBhdXRvciBwYXJhIG90b3JnYXIgYSBsYSBVbml2ZXJzaWRhZCBFbCBCb3NxdWUgbG9zIGRlcmVjaG9zIHJlcXVlcmlkb3MgcG9yIGVzdGEgbGljZW5jaWEsIHkgcXVlIGVzZSBtYXRlcmlhbCBjdXlvcyBkZXJlY2hvcyBzb24gZGUgdGVyY2Vyb3MgZXN0w6EgY2xhcmFtZW50ZSBpZGVudGlmaWNhZG8geSByZWNvbm9jaWRvIGVuIGVsIHRleHRvIG8gY29udGVuaWRvIGRlbCBkb2N1bWVudG8gZW50cmVnYWRvLgoKNS4gU2kgZWwgZG9jdW1lbnRvIHNlIGJhc2EgZW4gdW5hIG9icmEgcXVlIGhhIHNpZG8gcGF0cm9jaW5hZGEgbyBhcG95YWRhIHBvciB1bmEgYWdlbmNpYSB1IG9yZ2FuaXphY2nDs24gZGlmZXJlbnRlIGRlIGxhIFVuaXZlcnNpZGFkIEVsIEJvc3F1ZSwgc2UgcHJlc3Vwb25lIHF1ZSBzZSBoYSBjdW1wbGlkbyBjb24gY3VhbHF1aWVyIGRlcmVjaG8gZGUgcmV2aXNpw7NuIHUgb3RyYXMgb2JsaWdhY2lvbmVzIHJlcXVlcmlkYXMgcG9yIGVzdGUgY29udHJhdG8gbyBhY3VlcmRvLgoKNi4gVW5pdmVyc2lkYWQgRWwgQm9zcXVlIGlkZW50aWZpY2Fyw6EgY2xhcmFtZW50ZSBzdS9zIG5vbWJyZS9zIGNvbW8gZWwvbG9zIGF1dG9yL2VzIG8gcHJvcGlldGFyaW8vcyBkZSBsb3MgZGVyZWNob3MgZGVsIGRvY3VtZW50bywgeSBubyBoYXLDoSBuaW5ndW5hIGFsdGVyYWNpw7NuIGRlIHN1IGRvY3VtZW50byBkaWZlcmVudGUgYSBsYXMgcGVybWl0aWRhcyBlbiBlc3RhIGxpY2VuY2lhLgo=

Publicaciones similares