AVALIAÇÃO PRÉ-OPERATÓRIA MULTIDIMENSIONAL E SEU PAPEL NA PREVENÇÃO DE COMPLICAÇÕES PERIOPERATÓRIAS EM IDOSOS COM FRATURAS

Amanda Valim Kampa Cassab; Flamarion dos Santos Batista; Jurandir Marcondes Ribas-Filho; Paulo Afonso Nunes Nassif; Fernando Issamu Tabushi; Jose Eduardo Ferreira Manso; Orlando Jorge Martins Torres; Thelma Larocca Skare

doi:10.1590/SciELOPreprints.9305

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Amanda Valim Kampa Cassab Faculdade Evangélica Mackenzie do Paraná
Flamarion dos Santos Batista Faculdade Evangélica Mackenzie do Paraná
Jurandir Marcondes Ribas-Filho Faculdade Evangélica Mackenzie do Paraná
Paulo Afonso Nunes Nassif Faculdade Evangélica Mackenzie do Paraná https://orcid.org/0000-0002-1752-5837
Fernando Issamu Tabushi Faculdade Evangélica Mackenzie do Paraná
Jose Eduardo Ferreira Manso Universidade Federal do Rio de Janeiro
Orlando Jorge Martins Torres Universidade Federal do Maranhão
Thelma Larocca Skare Faculdade Evangélica Mackenzie do Paraná

DOI:

https://doi.org/10.1590/SciELOPreprints.9305

Keywords:

Preoperative evaluation, Elderly, Fractures, Perioperative complications, Surgery

Abstract

Introduction: Elderly patients have higher rates of morbidity and mortality during hospitalizations, diagnostic and surgical procedures. In order to improve the quality of care for the elderly, the APOIO (Preoperative Assessment of Elderly and Care Guidance) protocol was created, a tool to measure the risks of surgical complications.

Objective: To evaluate the impact of APOIO on several outcomes, in order to validate it as a useful vehicle in the prevention of perioperative complications in elderly patients with fractures.

Method: Retrospective cross-sectional study through review of 218 medical records of elderly patients hospitalized for fractures, and with surgical indication, having collected data on sex, age, reason for hospitalization, type of fracture, indication or not of surgical treatment, evaluation or not by APOIO, indication or not of ICU in the postoperative period, length of ICU stay, total length of hospitalization, immediate outcome and outcome within 30 days after the operation.

Result: It was found that the application of APOIO was associated with a 70% reduction in the chances of death during hospitalization (p=0.040), length of stay in the ICU (p<0.001) and total length of hospital stay (p = 0.010). There was also a trend towards a reduction in the death rate within 30 days of the postoperative period (p = 0.117).

Conclusion: The application of the APOIO tool reduces the length of hospitalization, optimizes indication and length of stay in the ICU and, also, reduces the risk of death in elderly people undergoing surgical treatment for fractures.