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- Time to death in a prospective cohort of 252 patients treated for fracture of the proximal femur in a major hospital in PortugalPublication . Campos, Sónia; Alves, Sandra Maria; Carvalho, Marilia Sá; Neves, Nuno; Trigo-Cabral, Abel; Pina, Maria FátimaThe objectives were to analyze one-year survival and mortality predictors in patients with fracture of the proximal femur (low/moderate trauma). A prospective cohort was formed by inviting all patients hospitalized in the Orthopedic Ward of the second largest hospital in Portugal (May 2008-April 2009). Survival was assessed at 3, 6, 9, and 12 months after fracture and related to demographic factors, lifestyle, and clinical history, as well as to data from medical records (fracture type, surgery date, surgical treatment, and preoperative risk). Of the 340 patients hospitalized, 252 were included (78.9% women). Mortality at 3, 6, 9, and 12 months was 21.2%, 25%, 28.8%, and 34.6% for men and 7.8%, 13.5%, 19.2%, and 21.4% for women, respectively. Predictors of death were male gender (HR = 2.54; 95%CI: 1.40-4.58), ASA score III/IV vs. I/II (HR = 1.95; 95%CI: 1.10-3.47), age (HR = 1.06; 95%CI: 1.03-1.10), and delay in days to surgery (HR = 1.07; 95%CI: 1.03-1.12). Factors related to death were mainly related to patients' characteristics at admission.
- Bone decade actions: are practical results measurable yet?Publication . Alves, Sandra; Oliveira, Carla; Alves, Carlos; Ribeiro, Ana I.; Neves, Nuno; Pina, Maria F.Osteoarthritis (OA) has an extremely high disease and economic burden. Despite treatments for OA pain management, data are limited on the adequacy of pain relief in OA patients. SORT will determine the adequacy of pain relief in patients with knee OA and compare patterns of clinical care and outcomes.
- Osteoporotic hip fractures: Bisphosphonates sales and observed turning point in trend. A population-based retrospective studyPublication . Alves, Sandra Maria; Economou, Theodoros; Oliveira, Carla Maria; Ribeiro, Ana Isabel; Neves, Nuno; Goméz-Barrena, Enrique; Pina, Maria de FátimaThe aim is to examine the temporal trends of hip fracture incidence in Portugal by sex and age groups, and explore the relation with anti-osteoporotic medication. From the National Hospital Discharge Database, we selected from 1st January 2000 to 31st December 2008, 77,083 hospital admissions (77.4% women) caused by osteoporotic hip fractures (low energy, patients over 49 years-age), with diagnosis codes 820.x of ICD 9-CM. The 2001 Portuguese population was used as standard to calculate direct age-standardized incidence rates (ASIR) (100,000 inhabitants). Generalized additive and linear models were used to evaluate and quantify temporal trends of age specific rates (AR), by sex. We identified 2003 as a turning point in the trend of ASIR of hip fractures in women. After 2003, the ASIR in women decreased on average by 10.3 cases/100,000 inhabitants, 95% CI (− 15.7 to − 4.8), per 100,000 anti-osteoporotic medication packages sold. For women aged 65–69 and 75–79 we identified the same turning point. However, for women aged over 80, the year 2004 marked a change in the trend, from an increase to a decrease. Among the population aged 70–74 a linear decrease of incidence rate (95% CI) was observed in both sexes, higher for women: − 28.0% (− 36.2 to − 19.5) change vs − 18.8%, (− 32.6 to − 2.3). The abrupt turning point in the trend of ASIR of hip fractures in women is compatible with an intervention, such as a medication. The trends were different according to gender and age group, but compatible with the pattern of bisphosphonates sales.