Objective: The primary objective was to describe the clinical characteristics, management, and outcomes of centenarians with fragility hip fracture and compare them to other age groups. The secondary objective was to determine the variables associated with length of stay, in-hospital mortality and 30-day mortality. Materials and Methods: This is a secondary analysis of the Spanish National Hip Fracture Registry. We included patients ≥ 75 years admitted for fragility hip fractures in 86 Spanish hospitals between 2017 and 2019, dividing the sample into four age groups. The variables studied were baseline characteristics, type of fracture, management, length of stay, in-hospital mortality and 30-day mortality. Results: We included 25,938 patients (2888 were 75– 79 years old; 14,762 octogenarians; 8,035 nonagenarians and 253 centenarians). Of the centenarians, 83% were women, 33% had severe dementia, 9% had severe dependency and 36% lived in residential care homes. Six out of ten had intertrochanteric fracture. Length of hospital stay was 8.6 days; in-hospital mortality was 10.3% and 30-day mortality 20.9%. Older age groups had more women, severe functional dependency, severe dementia, intertrochanteric fracture, living in care facilities and being discharged to nursing care. They had less frequent early mobilization, osteoporosis treatment and discharge to rehabilitation units. In-hospital and 30-day mortality were higher with increasing age. In centenarians, time to surgery > 48 hours was independently associated with length of stay (correlation coefficient 3.99 [95% CI: 2.35– 5.64; p< 0.001]) and anaesthetic risk, based on an ASA score of V, was related to 30-day mortality (ASA score II [OR 0.25, 95% CI: 0.09– 0.70; p=0.009] and ASA score III [OR 0.43, 95% CI: 0.19– 0.96; p=0.039]). Conclusion: Centenarians had different clinical characteristics, management and outcomes. Although centenarians had worse outcomes, nearly 4 out of 5 centenarians were alive one month after surgery.

Las infecciones respiratorias agudas (IRA) son una de las principales causas de morbilidad, deterioro funcional y mortalidad en personas mayores institucionalizadas. Este grupo es altamente vulnerable debido a factores como la edad avanzada, la multimorbilidad, la fragilidad y las barreras estructurales para la prevención y el control de infecciones. Este artículo revisa, en formato de preguntas y respuestas, la evidencia más reciente sobre la epidemiología, la prevención y el tratamiento de las infecciones respiratorias más relevantes en residencias: gripe, SARS-CoV-2, virus respiratorio sincitial (RSV) y Streptococcus pneumoniae. Se analizan los cambios epidemiológicos tras la pandemia de COVID-19, las estrategias de vacunación actuales, la eficacia y características de las nuevas vacunas disponibles, así como el enfoque terapéutico actualizado según los perfiles de resistencia y la disponibilidad de antivirales. Además, se aborda el impacto clínico y funcional que estas infecciones pueden tener en los residentes, así como la necesidad de encontrar un equilibrio entre las medidas preventivas y la calidad de vida de este grupo poblacional. Se destaca la importancia de una coordinación eficaz entre los profesionales sanitarios y sociales, y de la implementación de protocolos adaptados al contexto residencial. El artículo ofrece recomendaciones prácticas basadas en la evidencia para mejorar la prevención y el tratamiento de estas infecciones en un entorno especialmente vulnerable.