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Objective To identify the predictive factors for the need for transfusion during and after surgery to treat hip fractures in the elderly and to evaluate a protocol to guide the request for blood reserves for surgery. Methods The medical records of 172 elderly patients undergoing surgical treatment for proximal femoral fractures were collected. Data on sex, age, preoperative hemoglobin level, diagnosis, and type of surgery were tested for correlation with blood transfusion. In our sample, we determined the number of units of packed red blood cells reserved, the transfusion rate, and the cross-test:transfusion ratio. We made the same calculations in a hypothetical situation in which the request for blood reserves for our sample followed the criteria of a defined protocol. Results We found a correlation between the American Society of Anesthesiologists (ASA) classification and the occurrence of transfusions, and an inverse correlation between the hemoglobin level on admission and the number of bags transfused. A reserve of 328 units of packed red blood cells was requested for 167 surgeries. Had the proposed protocol been applied, 72 units would have been requested for 61 surgeries. Conclusion We found a correlation regarding the variables ASA classification and preoperative hemoglobin level and the occurrence of transfusion. Applying a proposed protocol to decide between requesting a reserve and only typing for elderly individuals undergoing surgical treatment for hip fracture proved suitable to reduce the number of packed red blood cell reserves.
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Objetivo: Estabelecer a capacidade física e alterações do controle postural (COP) durante o apoio unipodal estático e dinâmico em mulheres com Síndrome de Dor no Grande Trocânter (SDGT). Métodos: Foram avaliadas 36 mulheres, sedentárias, maiores de 45 anos. Destas, 18 tinham diagnóstico de SDGT (Grupo Dor - GD) e 18 sem queixas álgicas (Grupo Controle - GC). Todas responderam ao questionário Victorian Institute of Sports Assessment for Gluteal Tendinopathy (VISA-G) para análise da capacidade física relacionada a dor lateral do quadril, e foram submetidas à avaliação do controle postural na plataforma de força, em apoio unipodal estático e dinâmico (mini agachamentos). Os dados foram comparados e correlacionados, com significância estatística estabelecida 5%. Resultados: As participantes do GD apresentaram alto índice de dor (7), por 10 meses e baixa capacidade funcional (54,44 pontos no VISA-G). Na análise do controle postural estático, GD mostrou piores resultados para a área de oscilação do COP (p= 0,04) e maior amplitude de oscilação médio-lateral (p= 0,03). Na avaliação dinâmica, os resultados da amplitude médio-lateral (p= 0,02) e velocidade antero posterior (p= 0,04) foram maiores no GD, mas o COP foi pior no GC (p= 0,01). Conclusão: Mulheres com SDGT tem baixa capacidade funcional e pior controle postural estático e dinâmico. Estas variáveis devem ser avaliadas para estabelecer novas estratégias de prevenção e reabilitação em mulheres com SDGT
Objective: To establish physical capacity and changes in postural control (PCO) during static and dynamic single-legged support in women with Greater Trochanter Pain Syndrome (GTPS). Methods: A total of 36 sedentary women over 45 years of age were evaluated. Of these, 18 had a diagnosis of GTPS (Pain Group - DG), and 18 had no pain complaints (Control Group - CG). All participants answered the Victorian Institute of Sports Assessment for Gluteal Tendinopathy (VISA-G) questionnaire to analyze their physical capacity regarding lateral hip pain. Therefore, were submitted to the evaluation of postural control on the force platform in static and dynamic single-legged support (mini squats). The data were compared and correlated, with statistical significance established at 5%. Results: The participants in the DG presented a high pain index (7) for 10 months and low functional capacity (54.44 points in the VISA-G). In the analysis of static postural control, DG showed worse results for the Center of Pressure (COP) oscillation area (p= 0.04) and greater amplitude of mediolateral oscillation (p= 0.03). In the dynamic evaluation, the results of the mediolateral amplitude (p= 0.02) and anteroposterior velocity (p= 0.04) were higher in the DG, but the COP was worse in the CG (p= 0.01). Conclusion: Women with GTPS have lower functional capacity and worse static and dynamic postural control. These variables should be evaluated to establish new prevention and rehabilitation strategies for women with GTPS
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INTRODUCTION: There are many studies on the Greater Trochanteric Pain Syndrome (GTPS), however its relationship with radiographic and biomechanics parameters is not established. OBJECTIVE: To compare the magnetic resonance images (MRI) of the hip, radiographic parameters of sagittal alignment (pelvic incidence, sacral slope and lumbar lordosis), muscular strength and endurance in women with and without GTPS. METHODS: Forty women, age over 45, IMC <30 Kg/m2 and sedentary, were recruited and distributed in two groups: GTPS group (GTPSG, n = 20) and Control group (CG, n = 20). All participants underwent MRI scans and X-ray for sagittal alignment analysis in the hip and performed tests for muscular strength and endurance of the hip and trunk. RESULTS: No differences were found between the GTPSG and CG for the frequency of tendinopathy (P = .30), peritendinitis (P = .10), bursitis (P = .68) and enthesitis (P = .15), however the gluteus medius tendon tear was more prevalent in GTPSG (P = .05). There were no differences in radiographic parameters for pelvic incidence (P > .05), sacral slope (P > .05) and lumbar lordosis (P > .05). The GTPSG showed lower strength of all hip muscle groups (abductors, adductors, flexors, extensors and rotators; P < .01 for all), as well as lower endurance in the Supine Bridge test and Prone bridge test (P < .01). CONCLUSION: The results of the MRI and radiographic parameters did not differentiate women with and without GTPS. However, the evaluation of muscle strength and endurance can establish the difference between groups.