Key words: Anxiety; Depression; Geriatric Assessment; Hip Fractures

The effect of hypothermia as a mortality risk factor at 30 days in the elderly who had hip fracture (HF) surgery is still controversial because it may be due to a set of poorly identified factors. In this study, we aim to determine if exposure to intra and immediate postoperative hypothermia increases the incidence of mortality at 30 days in elderly patients who had HF surgery. Survival study in the elderly who had HF surgery with and without exposure to hypothermia. Sociodemographic, anesthetic and surgical factors were collected. The temperature of the rectum was measured at the end of the surgery and in the recovery room. The effect of hypothermia was analyzed by the incidence of mortality at 30 days. Other results were considered, such as, surgical site infection (SSI), blood transfusions, and influence of implants used in the 30-day mortality. Three hundred eighty five subjects were eligible, to include 300. Inadvertent hypothermia was 12%, the 30-day overall mortality was 9% and in subjects with hypothermia it was 25% (P = .002). Subjects with hypothermia had a higher risk of SSI (relative risk 4.2, 95% confidence interval 1.3–13.6, P = .03) and receive more transfusions (relative risk 3.6, 95% confidence interval 2.0–6.5, P < .001). Elderly subjects with HF exposed to hypothermia who undergo hip hemiarthroplasty and who receive 2 or more blood transfusions during their treatment, are at greater risk of dying after 30 days of the surgery. Hypothermia, as a possible causative factor of mortality, should continue to be studied.

Knee osteoarthritis can be accompanied by depression and obesity, which could affect the quality of life (QOL) and function after a total knee arthroplasty (TKA). To compare the QOL in subjects with depression and obesity 5 years after TKA. Cross-sectional study of prospectively collected data, with two and three groups based on depression and obesity status. Sociodemographic variables, QOL and pain were compared. Depression was evaluated with a screening geriatric depression questionnaire used in the Mexican Health and Age Study (CENASEM). QOL was evaluated with the health survey SF-36. 378 participants were reviewed, 266 were included. Depression was detected in 24.1%, female (p < 0.001), with comorbidity (p = 0.04) and anxiety (p < 0.001), and the QOL score in subjects with depression was lower (p < 0.001). Obese subjects had greater pain (analogous visual scale 3 vs. 2; p = 0.002) and affection of the vitality domain in the QOL (75 vs. 80; p = 0.02). Evaluating depression and QOL with questionnaires such as CENASEM and SF-36 in elderly subjects who undergo ATR should be indispensable, since detecting and treating depression could increase QOL and function. Obese elderly with TKA may present greater pain.

Objective: To evaluate whether an association exists between gonarthrosis and metabolic syndrome X (MS) as well as other potential risk factors. Method: Comparative cross-sectional study of 310 patients evaluated by pathology of knee grouped in patients with gonarthrosis and without it. Sociodemographic, anthropometric and laboratory data was obtained. Gonarthrosis was defined as a & GE; 2 score in Kellgren-Lawrence radiological scale, and MS was assessed using the International Diabetes Federation criteria. Odds ratio and logistic regression were used for bivariate and multivariate analysis respectively. Results: The prevalence of MS in patients who had gonarthrosis was 79.9%, statistically higher than in patients without gonarthrosis (p = 0.001). Other factors that had a statistically higher frequency in this group included diabetes mellitus (p = 0.02) and hypertension (p = 0.02). Multivariate analysis revealed MS had an association with a higher prevalence of gonarthrosis (p = 0.003), while high density lipoproteins (p = 0.02) was associated with a lower prevalence. Conclusions: MS and its re-lated alterations are associated to gonarthrosis; their adequate control could prevent patients from developing the disease.

Keywords: Condyle; Children; Fractures, Salter-Harris; Elbow joint; Observer variation