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[股骨颈骨折老年患者步行质量及预后的康复结果。一年后的进展]

[Results of rehabilitation on quality of walking and outcome in elderly patients following femoral neck fracture. Development after one year].

作者信息

Bovy P, Jolly S, Dropsy S, Sacre F

机构信息

Service de médecine physique, CHR Citadelle, boulevard du XIIe de Ligne, B-4000, Liége, Belgique, France.

出版信息

Ann Readapt Med Phys. 2002 Jan;45(1):19-25. doi: 10.1016/s0168-6054(01)00168-4.

Abstract

OBJECTIVES

To examine effects of coordinated multidisciplinary inpatient rehabilitation for older patients with hip fractures.

MATERIAL AND METHOD

187 (42 men and 147 women: mean age 80.9 +/- 8.4 years) admitted with a diagnosis of fracture neck of femur. Before fracture 183 patients were living in their own house. We examine medical state before fracture, type of fracture, type of surgery, walking performance at hospital discharge and at one year, destination at this discharge, living location and quality of life at one year.

RESULTS

The length stay after intracapsular fracture and prosthesis is significatively lower (p<0.01). At discharge 28% were walking alone, 38% with stick, 17% with technical aid, 8% with human aid, 2% were bedridden and 7% were dead. After hospitalisation 7% were dead, 70% were living in their own homes, 18% were in old people's homes and 6% in another hospital. One year after fracture, 19% were dead, 65% were living in their own homes, 16% were in old people's homes. Older age, medical state before fracture and male gender was found to increase mortality risk following hip fracture (p<0.01).

CONCLUSIONS

Hip fracture is a major cause of morbidity in older people and its impact, both on the individual and to society is substantial. Many people do not return to their pre-fracture life style. Coordinated multidisciplinary care of patients with fractured neck of femur seems essential.

摘要

目的

探讨多学科协作的住院康复治疗对老年髋部骨折患者的影响。

材料与方法

187例(42例男性,147例女性:平均年龄80.9±8.4岁)因股骨颈骨折入院。骨折前183例患者居住在自己家中。我们检查了骨折前的医疗状况、骨折类型、手术类型、出院时及1年后的行走能力、出院目的地、居住地点以及1年后的生活质量。

结果

囊内骨折及假体置换后的住院时间显著缩短(p<0.01)。出院时,28%的患者可独立行走,38%需借助拐杖,17%需借助辅助器械,8%需他人协助,2%卧床不起,7%死亡。住院后,7%的患者死亡,70%居住在自己家中,18%住在养老院,6%转至其他医院。骨折1年后,19%的患者死亡,65%居住在自己家中,16%住在养老院。研究发现,年龄较大、骨折前的医疗状况及男性性别会增加髋部骨折后的死亡风险(p<0.01)。

结论

髋部骨折是老年人发病的主要原因,对个人和社会都有重大影响。许多人无法恢复到骨折前的生活方式。对股骨颈骨折患者进行多学科协作的综合护理似乎至关重要。

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