Huusko T, Karppi P, Avikainen V, Kautiainen H, Sulkava R
Department of Rehabilitation, Central Hospital of Central Finland, Jyväskylä.
Ann Chir Gynaecol. 1999;88(1):55-60.
The objective of this study is to determine the changes occurring in the treatment chain and mortality of hip fracture patients in Central Finland over a ten-year period. In order to cope with an aging population and increasing cutbacks in the health care system, health-center hospitals run by general practitioners have taken a more active role in the rehabilitation of elderly patients.
Patients with acute hip fracture admitted to Jyväskylä Central Hospital in 1982-1983 (n = 317) and in 1992-1993 (n = 351) were collected from the hospital discharge register and the medical records of these patients were studied retrospectively.
The median length of central hospital stay diminished from 18 days to 5 days and the percentage of hip fracture patients discharged to cope on their own diminished from 22 % to only 7 %. The percentage of trochanteric fractures treated by osteosynthesis increased from 83 % to 96 % and the percentage of cervical fractures treated by hemiprosthesis increased from 35 % to 76 %. First-year mortality has remained almost unchanged.
There has been a dramatic change in surgical methods, in the length of hospital stay on the traumatology ward, and in discharge patterns and no change in mortality during the last 10 years in Central Finland.
本研究的目的是确定芬兰中部地区髋部骨折患者在十年间治疗流程及死亡率的变化情况。为应对人口老龄化及医疗保健系统日益缩减的开支，由全科医生管理的保健中心医院在老年患者康复过程中发挥了更积极的作用。
从医院出院登记册中收集1982 - 1983年（n = 317）和1992 - 1993年（n = 351）入住于于韦斯屈莱中心医院的急性髋部骨折患者，并对这些患者的病历进行回顾性研究。
中心医院住院时间中位数从18天减至5天，出院后需自行应对的髋部骨折患者比例从22%降至仅7%。通过骨合成术治疗的转子间骨折比例从83%增至96%，通过半髋关节置换术治疗的颈椎骨折比例从35%增至76%。第一年死亡率几乎保持不变。
在过去十年中，芬兰中部地区的手术方法、创伤科病房住院时间、出院模式发生了显著变化，死亡率则无变化。
