Fratura de quadril em idosos: tempo de abordagem cirúrgica e sua associação quanto a delirium e infecção

SUMMARY Hip fracture is an important problem for the Public Health System. It is estimated that 100,000 fractures happen each year in Brazil. The mean mortality rate after one year of the fracture is 30%. Surgical management is crucial in these cases. This study was aimed at in- vestigating if elderly patients with hip fractures treated after 48 hours of admission showed a higher incidence of delirium and infections than those operated within 48 hours. A prospective observational study was carried out in 21 elderly patients over a six-month period in Hospital do Servidor Publico Municipal of Sao Paulo. Only 4 patients (19%) were operated within 48 hours of admission. Postoperative delirium was seen in 52% of the patients. Complications such as pneumonia, urinary tract infection, and wound infection were found in 28.5% of the patients. Eighty three percent of the infected patients were treated after 48 hours of admission and seventeen percent were treated within 48 hours. The main cause of surgery delay was bureaucracy. The correlation between surgical treatment timing and its impact on survival rate is still controversial. In this study, surgical treatment after 48 hours of admission was associated with a higher frequency of complications such as infections and delirium.