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老年患者髋部骨折:功能、生活质量及居住类型的预后

Hip fracture in elderly patients: outcomes for function, quality of life, and type of residence.

作者信息

van Balen R, Steyerberg E W, Polder J J, Ribbers T L, Habbema J D, Cools H J

机构信息

Geriatric Centre and Nursing Home Antonius Binnenweg, Rotterdam, The Netherlands.

出版信息

Clin Orthop Relat Res. 2001 Sep(390):232-43.

Abstract

A prospective study was done to investigate functional outcome, quality of life, and type of residence after hip fracture in patients 65 years of age and older. One hundred two patients admitted consecutively to a university and a general hospital were followed up as long as 4 months after admission. The mean age of the participants was 83 years; 58% of patients came from their own home, and 42 % of patients came from institutions. Nearly 70% of patients had two or more diagnoses other than the hip fracture. Cumulative mortality was 20% at 4 months after fracture. Of surviving patients, 57% were back in their original situation for accommodation, 43% reached the same level of walking ability, and 17% achieved the same level of activities of daily living as before fracture. Patients experienced on average three complications, 26% of which were severe. Quality of life improved in the followup period of 4 months; however, the quality of life at 4 months was worse than the quality of life reported in a reference population. Average costs amounted to euro (Euro) 15.338 (which at the time was nearly equivalent to the US dollar) per patient, with nearly 50% of the costs attributable to hospital costs and 30% attributable to nursing home costs. The results of this study show a poor outcome after hip fracture in elderly patients.

摘要

一项前瞻性研究旨在调查65岁及以上髋部骨折患者的功能预后、生活质量和居住类型。连续入住一所大学医院和一所综合医院的102例患者在入院后长达4个月的时间里接受了随访。参与者的平均年龄为83岁;58%的患者来自自己家中,42%的患者来自养老机构。近70%的患者除髋部骨折外还有两种或更多种诊断。骨折后4个月的累积死亡率为20%。在存活患者中,57%恢复到原来的居住状况,43%达到相同的行走能力水平,17%恢复到骨折前相同的日常生活活动水平。患者平均经历三种并发症,其中26%为严重并发症。在4个月的随访期内生活质量有所改善;然而,4个月时的生活质量比参考人群报告的生活质量更差。每位患者的平均费用为15338欧元(当时几乎等同于美元),其中近50%的费用归因于医院费用,30%归因于疗养院费用。这项研究的结果显示老年患者髋部骨折后的预后较差。

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