Vol. 13. Núm. 62.
Páginas 3659-3670 (Septiembre 2022)

Actualización
Caídas y fractura de cadera

Falls and hip fracture

A. López IglesiasL.A. Hernández SánchezJ. Mateos-NozalM.L. Álvarez Nebreda
Doi : https://10.1016/j.med.2022.08.018
Opciones
Resumen

Las caídas son uno de los principales síndromes geriátricos. Suponen, debido al envejecimiento poblacional y a su elevada incidencia, un problema de salud pública que puede tener consecuencias devastadoras. Son causa de dependencia funcional, institucionalización y pérdida de calidad de vida. Requieren una evaluación profunda que incluya un cribado de los factores de riesgo para sufrir una caída, y una valoración multidimensional que permita diseñar intervenciones específicas. Una de las consecuencias más graves es la fractura de cadera. Los mayores que las presentan se benefician de una valoración multidisciplinar médico-quirúrgica para asegurar un tratamiento integrado específico que permita detectar y tratar precozmente complicaciones, y fomentar la recuperación funcional. Con este objetivo surgió la ortogeriatría, que es un modelo de asistencia multidisciplinar que incluye diversas especialidades médicas y quirúrgicas, así como otras disciplinas (enfermería, fisioterapia, trabajo social, etc.) que tienen como objetivo fundamental restaurar la capacidad funcional previa de estos pacientes.

Palabras clave
Adulto mayor
Caídas
Fractura de cadera
Ortogeriatría
Abstract

Falls are one of the main geriatric syndromes. Due to population aging and their high incidence, they represent a public health problem that can have devastating consequences. They are a cause of functional dependence, institutionalization, and loss of quality of life. They require an in-depth assessment that includes screening for the risk factors for having a fall and a multidimensional evaluation that allows for designing specific interventions. One of the most severe consequences is hip fracture. Older adults who have them benefit from a multidisciplinary medical-surgical assessment to ensure specific, comprehensive treatment that allows for the early detection and treatment of complications and the promotion of functional recovery. With this aim, orthogeriatrics has emerged. Orthogeriatrics is a multidisciplinary care model that includes various medical and surgical specialties as well as other disciplines (nursing, physical therapy, social work, etc.) with the fundamental objective of restoring these patients’ previous functional capacity.

Keywords
Older adults
Falls
Hip fracture
Orthogeriatrics

Identifíquese

¿Aún no es suscriptor de la revista?

Comprar el acceso al artículo

Comprando el artículo el pdf del mismo podrá ser descargado

Teléfono para incidencias

De lunes a viernes de 9h a 18h (GMT+1) excepto los meses de julio y agosto que será de 9 a 15h

Llamadas desde España 932 415 960
Llamadas desde fuera de España +34 932 415 960
Bibliografía
[1]
Documento
202209070540296268
de consenso sobre prevención de fragilidad y caídas en la persona mayor. Estrategia de promoción de la salud y prevención en el SNS. Informes, estudios e investicación 2014. Ministerio de Sanidad, Servicios Sociales e Igualdad.
[2]
L.Z. Rubenstein
202209070540296269
.
Falls in older people: epidemiology, risk factors and strategies for prevention.
Age Ageing., (2006), 35 pp. 37-41
[3]
Appeadu
2022090705402962610
M, Bordoni B. Falls and fall prevention in the elderly. En: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021. Disponible en: http://www.ncbi.nlm.nih.gov/books/NBK560761/[Consultado 19 Dic 2021].
[4]
Australian
2022090705402962611
Commission on Safety and Quality in Healthcare: Preventing falls and harm from falls in older people. Best practice guidelines for Australian hospitals and residential aged care facilities. 2009. Australian Commission on Safety and Quality in Healthcare Canberra (Australia). Disponible en: http://www.health.gov.au/Internet/safety/publishing.nsf/content/FallsGuidelines. [Consultado 19 Dic 2021].
[5]
M.L. Álvarez-Nebreda
2022090705402962612
, I. Bartolomé-Martín, F. Brañas Baztán, M.A. Caballero Mora, A. Casas Herrero, et al.
Manual de manejo de las personas mayores que sufren caídas. De la evidencia cientifica a la práctica clínica.
Sociedad Española de Medicina Geriátrica (SEMEG), (2019),
[6]
R.A. Kenny
2022090705402962613
, D.A. Richardson, N. Steen, R.S. Bexton, F.E. Shaw, J. Bond.
Carotid sinus syndrome: a modifiable risk factor for nonaccidental falls in older adults (SAFE PACE).
J Am Coll Cardiol., (2001), 38 pp. 1491-1496
[7]
C. Sherrington
2022090705402962614
, H.B. Menz.
An evaluation of footwear worn at the time of fall-related hip fracture.
Age Ageing., (2003), 32 pp. 310-314
[8]
C.E. Gleason
2022090705402962615
, R.E. Gangnon, B.L. Fischer, J.E. Mahoney.
Increased risk for falling associated with subtle cognitive impairment: secondary analysis of a randomized clinical trial.
Dement Geriatr Cogn Disord., (2009), 27 pp. 557-563
[9]
L.M. Allan
2022090705402962616
, C.G. Ballard, E.N. Rowan, R.A. Kenny.
Incidence and prediction of falls in dementia: a prospective study in older people.
[10]
F. El-Khoury
2022090705402962617
2022090705402962618
, B. Cassou, M.-A. Charles, P. Dargent-Molina.
The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults: systematic review and meta-analysis of randomised controlled trials.
BMJ., (2013), 347 pp. f6234
[11]
A. Peterson
2022090705402962619
, N. Mattek, A. Clemons, G.L. Bowman, T. Buracchio, J. Kaye, et al.
Serum vitamin D concentrations are associated with falling and cognitive function in older adults.
J Nutr Health Aging., (2012), 16 pp. 898-901
[12]
NICE
2022090705402962620
2022090705402962621
National Institute for Health and Care Excellence.
Clinical Guideline CG161. Falls in older people: assessing risk and prevention.
NICE, (2013),
[13]
J. Parkkari, P. Kannus, M. Palvanen, A. Natri, J. Vainio, H. Aho, et al.
Majority of hip fractures occur as a result of a fall and impact on the greater trochanter of the femur: A prospective controlled hip fracture study with 206 consecutive patients.
Calcif Tissue Int., (1999), 65 pp. 183-187
[14]
C. Cooper
2022090705402962622
, G. Campion, L.J. Melton.
Hip fractures in the elderly: a world-wide projection.
Osteoporos Int., (1992), 2 pp. 285-289
[15]
M.L. Álvarez-Nebreda
2022090705402962623
, A.B. Jiménez, P. Rodríguez, J.A. Serra.
Epidemiology of hip fracture in the elderly in Spain.
[16]
B. Abrahamsen
2022090705402962624
, T. van Staa, R. Ariely, M. Olson, C. Cooper.
Excess mortality following hip fracture: a systematic epidemiological review.
Osteoporos Int., (2009), 20 pp. 1633-1650
[17]
R.S. Garden.
Low-angle fixation in fractures of the femoral neck.
J Bone Joint Surg Br., (1961), 43 pp. 647-663
[18]
Duaso
2022090705402962625
2022090705402962626
E, Cancio JM, Llopis A, Santiago JM, Cuadra L, cords. Grupo de trabajo de ortogeriatría. Guía D’ Ortogeriatría. Societat Catalana de Geriatría i Gerontología. Disponible en: http://scgig.cat/docs [Consultado 7 Dic 2021].
[19]
T. Pareja Sierra
2022090705402962627
2022090705402962628
, J. Rodríguez Solis.
Tratamiento médico perioperatorio del anciano ingresado por fractura de cadera.
Med Clínica., (2014), 143 pp. 455-460
[20]
NICE
2022090705402962629
National Institute for Health and Care Excellence.
Clinical guideline CG124. Hip fracture: management.
NICE, (2017),
[21]
P. Falaschi
2022090705402962630
, D. Marsh.
Orthogeriatrics: The management of older patients with fragility fractures [Internet].
Springer International Publishing, (2021),
[22]
S. Walters
2022090705402962631
, T. Khan, T. Ong, O. Sahota.
Fracture liaison services: improving outcomes for patients with osteoporosis.
Clin Interv Aging., (2017), 12 pp. 117-127
[23]
P. Castillón, J.H. Nuñez, F. Mori-Gamarra, C. Ojeda-Thies, P. Sáez-López, J. Salvador, et al.
Hip fractures in Spain: are we on the right track? Statistically significant differences in hip fracture management between Autonomous Communities in Spain.
Arch Osteoporos., (2021), 16 pp. 40
[24]
J.I. González Montalvo
2022090705402962632
2022090705402962633
, T. Alarcón Alarcón, B. Pallardo Rodil, P. Gotor Pérez, J.L. Mauleón Álvarez de Linera, E. Gil Garay.
Ortogeriatría en pacientes Agudos (I). Aspectos Asistenciales.
Rev Espanola Geriatr Gerontol., (2008), 43 pp. 239-251
[25]
G. Pioli
2022090705402962634
, A. Giusti, A. Barone.
Orthogeriatric care for the elderly with hip fractures: where are we?.
Aging Clin Exp Res., (2008), 20 pp. 113-122
[26]
A. Giusti
2022090705402962635
, A. Barone, M. Razzano, M. Pizzonia, G. Pioli.
Optimal setting and care organization in the management of older adults with hip fracture.
Eur J Phys Rehabil Med., (2011), 47 pp. 281-296
[27]
C. Kammerlander
2022090705402962636
2022090705402962637
, T. Roth, S.M. Friedman, N. Suhm, T.J. Luger, U. Kammerlander-Knauer, et al.
Ortho-geriatric service--a literature review comparing different models.
Osteoporos Int J., (2010), 21 pp. S637-S646
[28]
K.V. Grigoryan
2022090705402962638
, H. Javedan, J.L. Rudolph.
Orthogeriatric care models and outcomes in hip fracture patients: a systematic review and meta-analysis.
J Orthop Trauma., (2014), 28 pp. e49-e55
[29]
J. Moyet
2022090705402962639
, G. Deschasse, B. Marquant, P. Mertl, F. Bloch.
Which is the optimal orthogeriatric care model to prevent mortality of elderly subjects post hip fractures? A systematic review and meta-analysis based on current clinical practice.
Int Orthop., (2019), 43 pp. 1449-1454
[30]
K. Mukherjee
2022090705402962640
, S.E. Brooks, R.D. Barraco, J.J. Como, F. Hwang, B.R.H. Robinson, et al.
Elderly adults with isolated hip fractures- orthogeriatric care versus standard care: A practice management guideline from the Eastern Association for the Surgery of Trauma.
J Trauma Acute Care Surg., (2020), 88 pp. 266-278
[31]
A. Van Heghe
2022090705402962641
2022090705402962642
, G. Mordant, J. Dupont, M. Dejaeger, M.R. Laurent, E. Gielen.
Effects of orthogeriatric care models on outcomes of hip fracture patients: A systematic review and meta-analysis.
Calcif Tissue Int., (2022), 110 pp. 162-184