Valoración preoperatoria y preparación para cirugía de cadera en el adulto mayor
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ene 30, 2023
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Resumen
Con el aumento del envejecimiento poblacional mundial, se han incrementado múltiples enfermedades crónicas no transmisibles, entre ellas la osteoporosis, que es una las principales causas de fracturas por fragilidad. La fractura de cadera es una de las principales causas de morbimortalidad y pueden ocasionar discapacidad. Por esto, es importante realizar una valoración preoperatoria que se basa en un abordaje integral. Este consiste en un manejo interdisciplinario, llamado comanejo médico-quirúrgico ortogeriátrico, cuyo propósito es la preservación de la funcionalidad y reducción de complicaciones hospitalarias a corto y mediano plazo. El objetivo de esta revisión narrativa es describir el abordaje de los pacientes con fractura de cadera, cómo y dónde se diagnostica, la valoración preoperatoria y su implicación en la práctica clínica diaria.
Keywords
hip fracture, aged, surgical clearencefractura de cadera, ancianos, valoración preoperatoria
References
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2. Friedman SM, Mendelson DA, Kates SL, McCann RM. Geriatric co-management of proximal femur fractures: Total quality management and protocol-driven care result in better outcomes for a frail patient population. J Am Geriatr Soc. 2008;56(7):1349-56.
3. Bengoa F, Carrasco M, Amenábar PP, Schweitzer D, Botello E, Klaber I. Perioperative care of older patients with hip fractures. Rev Med Chil. 2017;145(11):1437-46.
4. Papadakis MA, McPhee SJ, Rabow MW MK. Current Medical diagnosis & treatment 2022. New York: McGraw Hill; 2022.
5. Falaschi P, Marsh D, editores. Orthogeriatrics: the management of older patients with fragility fractures [internet]. 2.ª ed. 2020. Cham (CH): Springer. Disponible en: http://www.springer.com/series/15090
6. Ross AB, Lee KS, Chang EY, Amini B, Bussell JK, Gorbachova T, et al. ACR Appropriateness Criteria® acute hip pain-suspected fracture. J Am Coll Radiol. 2019;16(5):S18-25. https://doi.org/10.1016/j.jacr.2019.02.028
7. Magidson PD, Thoburn AK, Hogan TM. Emergency orthogeriatrics: concepts and therapeutic considerations for the geriatric patient. Emerg Med Clin North Am. 2020;38(1):15-29.
8. Organización Panamericana de la Salud. Clasificación estadística internacional de enfermedades y problemas relacionados con la salud. Washington; 1995.
9. The American Academy of Orthopaedic Surgeons. Management of hip fractures in older adults evidence-based clinical practice guideline [internet]. 2021. Disponible en: https://www.aaos.org/globalassets/quality-and-practice-resources/hip-fractures-in-the-elderly/hipfxcpg.pdf
10. Bardales Mas Y, González Montalvo JI, Abizanda Soler P, Alarcón Alarcón MT. Guías clínicas de fractura de cadera: comparación de sus principales recomendaciones. Rev Esp Geriatr Gerontol. 2012;47(5):220-7. http://dx.doi.org/10.1016/j.regg.2012.02.014
11. Foss NB, Kehlet H. Mortality analysis in hip fracture patients: implications for design of future outcome trials. Br J Anaesth. 2005;94(1):24-9. https://doi.org/10.1093/bja/aei010
12. Nijmeijer WS, Folbert EC, Vermeer M, Slaets JP, Hegeman JH. Prediction of early mortality following hip fracture surgery in frail elderly: The Almelo Hip Fracture Score (AHFS). Injury. 2016;47(10):2138-43. https://doi.org/10.1016/j.injury.2016.07.022
13. Mears SC, Kates SL. A guide to improving the care of patients with fragility fractures, edition 2. Geriatr Orthop Surg Rehabil. 2015;6(2):58-120.
14. Bhandari M, Swiontkowski M. Management of acute hip fracture. N Engl J Med. 2017;377(21):2053-62.
15. Malafarina V, Reginster JY, Cabrerizo S, Bruyère O, Kanis JA, Alfredo Martinez J, et al. Nutritional status and nutritional treatment are related to outcomes and mortality in older adults with hip fracture. Nutrients. 2018;10(5):1-26.
16. Fisher A, Srikusalanukul W, Fisher L, Smith PN. Lower serum P1NnP/βCTX ratio and hypoalbuminemia are independently associated with osteoporotic nonvertebral fractures in older adults. Clin Interv Aging. 2017;12:1131-40.
17. Ayus JC, Negri AL, Kalantar-Zadeh K, Moritz ML. Is chronic hyponatremia a novel risk factor for hip fracture in the elderly? Nephrol Dial Transplant. 2012;27(10):3725-31.
18. Wirth CD, Blum MR, Da Costa BR, Baumgartner C, Collet TH, Medici M, et al. Subclinical thyroid dysfunction and the risk for fractures: a systematic review and meta-analysis. Ann Intern Med. 2014;161(3):189-99.
19. Watson J, Lee M, Garcia-Casal MN. Consequences of inadequate intakes of vitamin A, vitamin B12, vitamin D, calcium, iron, and folate in older persons. Curr Geriatr Reports. 2018;7(2):103-13.
20. Duque G, Lord SR, Mak J, Ganda K, Close JJT, Ebeling P, et al. Treatment of osteoporosis in Australian residential aged care facilities: update on consensus recommendations for fracture prevention. J Am Med Dir Assoc. 2016;17(9):852-9.
21. Gomez F, Curcio CL, Brennan-Olsen SL, Boersma D, Phu S, Vogrin S, et al. Effects of the falls and fractures clinic as an integrated multidisciplinary model of care in Australia: a pre-post study. BMJ Open. 2019;9(7):1-9.
22. Siddaiah H, Patil S, Shelvan A, Ehrhardt KP, Stark CW, Ulicny K, et al. Preoperative laboratory testing: implications of “choosing wisely” guidelines. Best Pract Res Clin Anaesthesiol. 2020;34(2):303-14. https://doi.org/10.1016/j.bpa.2020.04.006
23. Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM. Erratum: Infectious diseases society of American guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis. 2005;40(10):1556.
24. Sendi P, Borens O, Wahl P, Clauss M, Uçkay I. Management of asymptomatic bacteriuria, urinary catheters and symptomatic urinary tract infections in patients undergoing surgery for joint replacement: a position paper of the Expert Group “Infection” of swissorthopaedics. J Bone Jt Infect. 2017;2(3):154-9.
25. Zhang Q, Liu L, Sun W, Gao F, Cheng L, Li Z. Research progress of asymptomatic bacteriuria before arthroplasty. Med (United States). 2018;97(7).
26. Sousa R, Muñoz-Mahamud E, Quayle J, Da Costa LD, Casals C, Scott P, et al. Is asymptomatic bacteriuria a risk factor for prosthetic joint infection? Clin Infect Dis. 2014;59(1):41-7.
27. Wilmore DW, Kehlet H. Clinical review: recent advances. Management of patients in fast track surgery. BMJ. 2001;322:473-6.
28. Kondo A, Yamaguchi C, Fujimoto E. Relationship between admission day and timing of surgery for patients with hip fracture. Japan J Nurs Sci. 2014;11(4):248-58.
29. Ceballos García G. La muerte en el anciano [tesis de diplomado en internet]. Ciudad de México: Asociación Mexicana de Tanatología; 2012. Disponible en: https://www.tanatologia-amtac.com/descargas/tesinas/149%20La%20muerte.pdf
30. Haleem S, Lutchman L, Mayahi R, Grice JE, Parker MJ. Mortality following hip fracture: Trends and geographical variations over the last 40 years. Injury. 2008;39(10):1157-63.
31. Flevas DA, Megaloikonomos PD, Dimopoulos L, Mitsiokapa E, Koulouvaris P, Mavrogenis AF. Thromboembolism prophylaxis in orthopaedics: an update. EFORT Open Rev. 2018;3(4):136-48.
32. Falck-Ytter Y, Francis CW, Johanson NA, Curley C, Dahl OE, Schulman S, et al. Prevention of VTE in orthopedic surgery patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed. American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141(2 suppl.):e278S-e325S. https://doi.org/10.1378/chest.11-2404
33. Van Grootven B, McNicoll L, Mendelson DA, Friedman SM, Fagard K, Milisen K, et al. Quality indicators for in-hospital geriatric co-management programmes: A systematic literature review and international Delphi study. BMJ Open. 2018;8(3):1-11.
34. Mendelson DA, Friedman SM. Principles of comanagement and the geriatric fracture center. Clin Geriatr Med. 2014;30(2):183-9. https://doi.org/10.1016/j.cger.2014.01.016
35. Glassou EN, Kristensen N, Møller BK, Erikstrup C, Hansen TB, Pedersen AB. Impact of preadmission anti-inflammatory drug use on the risk of RBC transfusion in elderly hip fracture patients: a Danish nationwide cohort study, 2005-2016. Transfusion. 2019;59(3):935-44.
36. Wright PM. Pain management interventions. Certif Hosp Palliat Nurse (CHPN ®) Exam Rev. 2019;(30).
37. Doleman B, Heinink TP, Read DJ, Faleiro RJ, Lund JN, Williams JP. A systematic review and meta-regression analysis of prophylactic gabapentin for postoperative pain. Anaesthesia. 2015;70(10):1186-204.
38. Tuncer S, Bariskaner H, Reisli R, Sarkilar G, C̀icekci F, Otelcioglu S. Effect of gabapentin on postoperative pain: a randomized, placebo-controlled clinical study. Pain Clin. 2005;17(1):95-9.
39. Peng PWH, Wijeysundera DN, Li CCF. Use of gabapentin for perioperative pain control: a meta-analysis. Pain Res Manag. 2007;12(2):85-92.
40. Trads M, Pedersen PU. Constipation and defecation pattern the first 30 days after hip fracture. Int J Nurs Pract. 2015;21(5):598-604.
41. Trads M, Deutch SR, Pedersen PU. Supporting patients in reducing postoperative constipation: fundamental nursing care: a quasi-experimental study. Scand J Caring Sci. 2018;32(2):824-32.
42. Tyler R, Barrocas A, Guenter P, Araujo Torres K, Bechtold ML, Chan LN, et al. Value of nutrition support therapy: impact on clinical and economic outcomes in the United States. J Parenter Enter Nutr. 2020;44(3):395-406.
43. Fierbinţeanu-Braticevici C, Raspe M, Preda AL, Livčāne E, Lazebnik L, Kiňová S, et al. Medical and surgical co-management: a strategy of improving the quality and outcomes of perioperative care. Eur J Intern Med. 2019;61(October 2018):44-7. https://doi.org/10.1016/j.ejim.2018.10.017
44. Lynch G, Tower M, Venturato L. Identifying outcomes associated with co-managed care models for patients who have sustained a hip fracture: An integrative literature review. Int J Orthop Trauma Nurs. 2015;19(3):140-54. https://doi.org/10.1016/j.ijotn.2014.07.002
45. Rath S, Yadav L, Tewari A, Chantler T, Woodward M, Kotwal P, et al. Management of older adults with hip fractures in India: a mixed methods study of current practice, barriers and facilitators, with recommendations to improve care pathways. Arch Osteoporos. 2017;12(1).
46. Fan J, Lv Y, Xu X, Zhou F, Zhang Z, Tian Y, et al. The efficacy of multidisciplinary team co-management program for elderly patients with intertrochanteric fractures: a retrospective study. Front Surg. 2022;8(February):1-7.
47. Dinamarca Montecinos J, Améstica Lazcano G, Carrasco Buvinic A. Mortalidad intrahospitalaria en adultos mayores chilenos con fractura de cadera: incidencia, causas y otros elementos de interés. Rev Chil Ortop Traumatol. 2018;59(2):41-6.
48. Magaziner J, Simonsick EM, Kashner TM, Hebel JR, Kenzora JE. Predictors of functional recovery one year following hospital discharge for hip fracture: a prospective study. J Gerontol. 1990;45(3):101-7.
49. Agency for Healthcare Research and Quality. Guide to inpatient quality indicators: quality of care in hospitals-volume, mortality, and utilization. Dep Heal Hum Serv. 2002;02-RO204.
50. González Montalvo JI, Alarcón Alarcón T, Pallardo Rodil B, Gotor Pérez P, Pareja Sierra T. Ortogeriatría en pacientes agudos (II): aspectos clínicos. Rev Esp Geriatr Gerontol. 2008;43(5):316-29.
51. Brox WT, Roberts KC, Taksali S, Wright DG, Wixted JJ, Tubb CC, et al. The American Academy of Orthopaedic Surgeons Evidence-Based Guideline on Management of Hip Fractures in the Elderly. J Bone Joint Surg Am. 2015 Jul 15;97(14):1196-9. https://doi.org/10.2106/JBJS.O.00229
52. Lin SN, Su SF, Yeh WT. Meta-analysis: effectiveness of comprehensive geriatric care for elderly following hip fracture surgery. West J Nurs Res. 2020;42(4):293-305.
53. Fernandez MA, Griffin XL, Costa ML. Management of hip fracture. Br Med Bull. 2015;115(1):165-72.
2. Friedman SM, Mendelson DA, Kates SL, McCann RM. Geriatric co-management of proximal femur fractures: Total quality management and protocol-driven care result in better outcomes for a frail patient population. J Am Geriatr Soc. 2008;56(7):1349-56.
3. Bengoa F, Carrasco M, Amenábar PP, Schweitzer D, Botello E, Klaber I. Perioperative care of older patients with hip fractures. Rev Med Chil. 2017;145(11):1437-46.
4. Papadakis MA, McPhee SJ, Rabow MW MK. Current Medical diagnosis & treatment 2022. New York: McGraw Hill; 2022.
5. Falaschi P, Marsh D, editores. Orthogeriatrics: the management of older patients with fragility fractures [internet]. 2.ª ed. 2020. Cham (CH): Springer. Disponible en: http://www.springer.com/series/15090
6. Ross AB, Lee KS, Chang EY, Amini B, Bussell JK, Gorbachova T, et al. ACR Appropriateness Criteria® acute hip pain-suspected fracture. J Am Coll Radiol. 2019;16(5):S18-25. https://doi.org/10.1016/j.jacr.2019.02.028
7. Magidson PD, Thoburn AK, Hogan TM. Emergency orthogeriatrics: concepts and therapeutic considerations for the geriatric patient. Emerg Med Clin North Am. 2020;38(1):15-29.
8. Organización Panamericana de la Salud. Clasificación estadística internacional de enfermedades y problemas relacionados con la salud. Washington; 1995.
9. The American Academy of Orthopaedic Surgeons. Management of hip fractures in older adults evidence-based clinical practice guideline [internet]. 2021. Disponible en: https://www.aaos.org/globalassets/quality-and-practice-resources/hip-fractures-in-the-elderly/hipfxcpg.pdf
10. Bardales Mas Y, González Montalvo JI, Abizanda Soler P, Alarcón Alarcón MT. Guías clínicas de fractura de cadera: comparación de sus principales recomendaciones. Rev Esp Geriatr Gerontol. 2012;47(5):220-7. http://dx.doi.org/10.1016/j.regg.2012.02.014
11. Foss NB, Kehlet H. Mortality analysis in hip fracture patients: implications for design of future outcome trials. Br J Anaesth. 2005;94(1):24-9. https://doi.org/10.1093/bja/aei010
12. Nijmeijer WS, Folbert EC, Vermeer M, Slaets JP, Hegeman JH. Prediction of early mortality following hip fracture surgery in frail elderly: The Almelo Hip Fracture Score (AHFS). Injury. 2016;47(10):2138-43. https://doi.org/10.1016/j.injury.2016.07.022
13. Mears SC, Kates SL. A guide to improving the care of patients with fragility fractures, edition 2. Geriatr Orthop Surg Rehabil. 2015;6(2):58-120.
14. Bhandari M, Swiontkowski M. Management of acute hip fracture. N Engl J Med. 2017;377(21):2053-62.
15. Malafarina V, Reginster JY, Cabrerizo S, Bruyère O, Kanis JA, Alfredo Martinez J, et al. Nutritional status and nutritional treatment are related to outcomes and mortality in older adults with hip fracture. Nutrients. 2018;10(5):1-26.
16. Fisher A, Srikusalanukul W, Fisher L, Smith PN. Lower serum P1NnP/βCTX ratio and hypoalbuminemia are independently associated with osteoporotic nonvertebral fractures in older adults. Clin Interv Aging. 2017;12:1131-40.
17. Ayus JC, Negri AL, Kalantar-Zadeh K, Moritz ML. Is chronic hyponatremia a novel risk factor for hip fracture in the elderly? Nephrol Dial Transplant. 2012;27(10):3725-31.
18. Wirth CD, Blum MR, Da Costa BR, Baumgartner C, Collet TH, Medici M, et al. Subclinical thyroid dysfunction and the risk for fractures: a systematic review and meta-analysis. Ann Intern Med. 2014;161(3):189-99.
19. Watson J, Lee M, Garcia-Casal MN. Consequences of inadequate intakes of vitamin A, vitamin B12, vitamin D, calcium, iron, and folate in older persons. Curr Geriatr Reports. 2018;7(2):103-13.
20. Duque G, Lord SR, Mak J, Ganda K, Close JJT, Ebeling P, et al. Treatment of osteoporosis in Australian residential aged care facilities: update on consensus recommendations for fracture prevention. J Am Med Dir Assoc. 2016;17(9):852-9.
21. Gomez F, Curcio CL, Brennan-Olsen SL, Boersma D, Phu S, Vogrin S, et al. Effects of the falls and fractures clinic as an integrated multidisciplinary model of care in Australia: a pre-post study. BMJ Open. 2019;9(7):1-9.
22. Siddaiah H, Patil S, Shelvan A, Ehrhardt KP, Stark CW, Ulicny K, et al. Preoperative laboratory testing: implications of “choosing wisely” guidelines. Best Pract Res Clin Anaesthesiol. 2020;34(2):303-14. https://doi.org/10.1016/j.bpa.2020.04.006
23. Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM. Erratum: Infectious diseases society of American guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis. 2005;40(10):1556.
24. Sendi P, Borens O, Wahl P, Clauss M, Uçkay I. Management of asymptomatic bacteriuria, urinary catheters and symptomatic urinary tract infections in patients undergoing surgery for joint replacement: a position paper of the Expert Group “Infection” of swissorthopaedics. J Bone Jt Infect. 2017;2(3):154-9.
25. Zhang Q, Liu L, Sun W, Gao F, Cheng L, Li Z. Research progress of asymptomatic bacteriuria before arthroplasty. Med (United States). 2018;97(7).
26. Sousa R, Muñoz-Mahamud E, Quayle J, Da Costa LD, Casals C, Scott P, et al. Is asymptomatic bacteriuria a risk factor for prosthetic joint infection? Clin Infect Dis. 2014;59(1):41-7.
27. Wilmore DW, Kehlet H. Clinical review: recent advances. Management of patients in fast track surgery. BMJ. 2001;322:473-6.
28. Kondo A, Yamaguchi C, Fujimoto E. Relationship between admission day and timing of surgery for patients with hip fracture. Japan J Nurs Sci. 2014;11(4):248-58.
29. Ceballos García G. La muerte en el anciano [tesis de diplomado en internet]. Ciudad de México: Asociación Mexicana de Tanatología; 2012. Disponible en: https://www.tanatologia-amtac.com/descargas/tesinas/149%20La%20muerte.pdf
30. Haleem S, Lutchman L, Mayahi R, Grice JE, Parker MJ. Mortality following hip fracture: Trends and geographical variations over the last 40 years. Injury. 2008;39(10):1157-63.
31. Flevas DA, Megaloikonomos PD, Dimopoulos L, Mitsiokapa E, Koulouvaris P, Mavrogenis AF. Thromboembolism prophylaxis in orthopaedics: an update. EFORT Open Rev. 2018;3(4):136-48.
32. Falck-Ytter Y, Francis CW, Johanson NA, Curley C, Dahl OE, Schulman S, et al. Prevention of VTE in orthopedic surgery patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed. American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141(2 suppl.):e278S-e325S. https://doi.org/10.1378/chest.11-2404
33. Van Grootven B, McNicoll L, Mendelson DA, Friedman SM, Fagard K, Milisen K, et al. Quality indicators for in-hospital geriatric co-management programmes: A systematic literature review and international Delphi study. BMJ Open. 2018;8(3):1-11.
34. Mendelson DA, Friedman SM. Principles of comanagement and the geriatric fracture center. Clin Geriatr Med. 2014;30(2):183-9. https://doi.org/10.1016/j.cger.2014.01.016
35. Glassou EN, Kristensen N, Møller BK, Erikstrup C, Hansen TB, Pedersen AB. Impact of preadmission anti-inflammatory drug use on the risk of RBC transfusion in elderly hip fracture patients: a Danish nationwide cohort study, 2005-2016. Transfusion. 2019;59(3):935-44.
36. Wright PM. Pain management interventions. Certif Hosp Palliat Nurse (CHPN ®) Exam Rev. 2019;(30).
37. Doleman B, Heinink TP, Read DJ, Faleiro RJ, Lund JN, Williams JP. A systematic review and meta-regression analysis of prophylactic gabapentin for postoperative pain. Anaesthesia. 2015;70(10):1186-204.
38. Tuncer S, Bariskaner H, Reisli R, Sarkilar G, C̀icekci F, Otelcioglu S. Effect of gabapentin on postoperative pain: a randomized, placebo-controlled clinical study. Pain Clin. 2005;17(1):95-9.
39. Peng PWH, Wijeysundera DN, Li CCF. Use of gabapentin for perioperative pain control: a meta-analysis. Pain Res Manag. 2007;12(2):85-92.
40. Trads M, Pedersen PU. Constipation and defecation pattern the first 30 days after hip fracture. Int J Nurs Pract. 2015;21(5):598-604.
41. Trads M, Deutch SR, Pedersen PU. Supporting patients in reducing postoperative constipation: fundamental nursing care: a quasi-experimental study. Scand J Caring Sci. 2018;32(2):824-32.
42. Tyler R, Barrocas A, Guenter P, Araujo Torres K, Bechtold ML, Chan LN, et al. Value of nutrition support therapy: impact on clinical and economic outcomes in the United States. J Parenter Enter Nutr. 2020;44(3):395-406.
43. Fierbinţeanu-Braticevici C, Raspe M, Preda AL, Livčāne E, Lazebnik L, Kiňová S, et al. Medical and surgical co-management: a strategy of improving the quality and outcomes of perioperative care. Eur J Intern Med. 2019;61(October 2018):44-7. https://doi.org/10.1016/j.ejim.2018.10.017
44. Lynch G, Tower M, Venturato L. Identifying outcomes associated with co-managed care models for patients who have sustained a hip fracture: An integrative literature review. Int J Orthop Trauma Nurs. 2015;19(3):140-54. https://doi.org/10.1016/j.ijotn.2014.07.002
45. Rath S, Yadav L, Tewari A, Chantler T, Woodward M, Kotwal P, et al. Management of older adults with hip fractures in India: a mixed methods study of current practice, barriers and facilitators, with recommendations to improve care pathways. Arch Osteoporos. 2017;12(1).
46. Fan J, Lv Y, Xu X, Zhou F, Zhang Z, Tian Y, et al. The efficacy of multidisciplinary team co-management program for elderly patients with intertrochanteric fractures: a retrospective study. Front Surg. 2022;8(February):1-7.
47. Dinamarca Montecinos J, Améstica Lazcano G, Carrasco Buvinic A. Mortalidad intrahospitalaria en adultos mayores chilenos con fractura de cadera: incidencia, causas y otros elementos de interés. Rev Chil Ortop Traumatol. 2018;59(2):41-6.
48. Magaziner J, Simonsick EM, Kashner TM, Hebel JR, Kenzora JE. Predictors of functional recovery one year following hospital discharge for hip fracture: a prospective study. J Gerontol. 1990;45(3):101-7.
49. Agency for Healthcare Research and Quality. Guide to inpatient quality indicators: quality of care in hospitals-volume, mortality, and utilization. Dep Heal Hum Serv. 2002;02-RO204.
50. González Montalvo JI, Alarcón Alarcón T, Pallardo Rodil B, Gotor Pérez P, Pareja Sierra T. Ortogeriatría en pacientes agudos (II): aspectos clínicos. Rev Esp Geriatr Gerontol. 2008;43(5):316-29.
51. Brox WT, Roberts KC, Taksali S, Wright DG, Wixted JJ, Tubb CC, et al. The American Academy of Orthopaedic Surgeons Evidence-Based Guideline on Management of Hip Fractures in the Elderly. J Bone Joint Surg Am. 2015 Jul 15;97(14):1196-9. https://doi.org/10.2106/JBJS.O.00229
52. Lin SN, Su SF, Yeh WT. Meta-analysis: effectiveness of comprehensive geriatric care for elderly following hip fracture surgery. West J Nurs Res. 2020;42(4):293-305.
53. Fernandez MA, Griffin XL, Costa ML. Management of hip fracture. Br Med Bull. 2015;115(1):165-72.
Cómo citar
Dueñas Orejuela, M. F., & Chavarro Carvajal, D. A. (2023). Valoración preoperatoria y preparación para cirugía de cadera en el adulto mayor. Universitas Medica, 64(1). https://doi.org/10.11144/Javeriana.umed64-1.vppc
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