A csípőtáji törések hazai ellátásának elemzése a 2004–2009 közötti időszakban | Analysis of hip fracture care in Hungary between 2004–2009

Absztrakt Bevezetes: A sulyos kimenetelű csipőtaji toresek leggyakrabban az egyre nagyobb reszaranyt kepviselő időskoru lakossag koreben fordulnak elő. Celkitűzes: A EuroHOPE kutatas regularis adatgyűjtesekre tamaszkodva 7 orszagban vizsgalta a csipőtaji toresek legfontosabb ellatasi jellemzőit es eredmenyeit. Modszer: A EuroHOPE kutatas reszekent a Magyarorszagon csipőtaji toreseket szenvedő betegek adatait dolgoztak fel a 2004. januar 1. es 2009. december 31. kozotti időszak korhazi felvetelei alapjan. Eredmenyek: 2004–2009 kozott a hospitalizalt esetszam lenyegesen nem valtozott. Az operalt betegek aranya 88% volt, ebből a combnyaktorottek aranya 41% koruli volt. A halalozasi mutatok a vizsgalt időszakban lenyegesen nem valtoztak. A combnyaktorottek standardizalt eves halalozasa protezis beultetesekor 28% koruli volt, ami nemileg kedvezőbb, mint egyeb műtetek alkalmazasakor. Tomportaji toreseknel az eves halalozas a nagyobb gyakorisaggal vegzett intramedullaris műtetek eseteben magasabb volt (36%). Nemzetkozi osszehasonlitasban az operaltak aranyaban lenyeges kulonbseg nem volt. A halalozas hazankban lenyegesen kedvezőtlenebb. A 30 napos standardizalt halalozas 2008-ban 13,6% volt, a finn, a holland, a norveg, a skot es a sved eredmenyek ketszerese. A 40%-os 365 napos halalozas a nemzetkozi mutatoknal lenyegesen magasabb volt. Kovetkeztetes: A hazai eredmenyek javitasahoz szukseges intezkedesek meghatarozasahoz az ellatas szisztematikus attekintese javasolt mind a korhazi, mind a kovető ellatasokra kiterjedően. Orv. Hetil., 2016, 157(41), 1642–1648. | Abstract Introduction: Proximal femoral fractures with severe outcome are most common in the increasing group of elderly patients. Aim: Based on the regular data gathered by the EuroHOPE research, the most important aspects and results of the treatment of proximal femoral fractures were studied. Method: Data of hospital admissions due to proximal femoral fractures were analyzed. Results: There was a slight increase in the number of hospitalized patients between 2004 and 2009 in Hungary. 88% of the patients received operative treatment, 41% suffered femoral neck fractures. Mortality rates did not change significantly in the analyzed period. Standardized annual mortality rates for patients who had suffered a femoral neck fracture were 28% when prosthesis was implanted; this result was somewhat more favorable than in case of other surgical procedures. Annual mortality rates were higher in the peritrochanteric fracture group where intramedullary nailing was performed (36%). The ratio of operated patients did not differ significantly from international results. Mortality rates in Hungary were significantly less favorable. 30 day standardized mortality rate was 13.6% in 2008, twice as high as the rate in Finland, The Netherlands, Norway, Scotland and Sweden. The 40% mortality rate calculated for 365 days was significantly higher than international results. Conclusion: To define the measures needed to improve results, systematic analysis of both in-hospital treatment protocols, and follow-up treatment is necessary. Orv. Hetil., 2016, 157(41), 1642–1648.