Ottenbacher Kenneth J, Smith Pam M, Illig Sandra B, Peek M Kristen, Fiedler Roger C, Granger Carl V
Center on Aging, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-1137, USA.
Arch Gerontol Geriatr. 2003 Jan-Feb;36(1):15-22. doi: 10.1016/s0167-4943(02)00052-3.
A significant percentage of older adults hospitalized and treated for hip fracture are readmitted to a hospital within six months. We analyzed information from a national database, the Uniform Data System for Medical Rehabilitation. Records for 8,236 patients (1994-98) who received inpatient medical rehabilitation following treatment for hip fracture were examined. Mean age was 76.51 years (S.D. = 12.48) with 71% female and 79% non-Hispanic White. The primary outcome measure was incidence of hospital readmission 0-180 days post-discharge. The hospital readmission rate was 16.7%. A Cox regression model predicting rehospitalization included the following variables (p < 0.05): basic daily living skills, age, length of stay, ethnicity, and gender. There was a statistically significant difference in the percent of male versus female patients rehospitalized for Hispanic subjects but not for non-Hispanic white or African American subjects. The greatest variability occurred among male patients. A total of 18.1% of non-Hispanic White males and 16.8% of African American males were rehospitalized. In contrast, only 10.1% of Hispanic males were rehospitalized. Basic daily living skills, length of hospital stay, age, ethnicity and gender were variables associated with hospital readmission following medical rehabilitation in persons with hip fracture. These variables should be considered in developing intervention programs to reduce the risk of hospital readmission.
因髋部骨折住院治疗的老年人中有很大比例在六个月内再次入院。我们分析了来自国家数据库——医学康复统一数据系统的信息。检查了8236名（1994 - 1998年）髋部骨折治疗后接受住院医疗康复患者的记录。平均年龄为76.51岁（标准差 = 12.48），女性占71%，非西班牙裔白人占79%。主要结局指标是出院后0至180天的再次入院发生率。再次入院率为16.7%。预测再次住院的Cox回归模型包括以下变量（p < 0.05）：基本日常生活技能、年龄、住院时间、种族和性别。西班牙裔患者中再次住院的男性与女性百分比存在统计学显著差异，但非西班牙裔白人或非裔美国患者中不存在这种差异。最大的变异性出现在男性患者中。共有18.1%的非西班牙裔白人男性和16.8%的非裔美国男性再次住院。相比之下，只有10.1%的西班牙裔男性再次住院。基本日常生活技能、住院时间、年龄、种族和性别是髋部骨折患者医疗康复后与再次入院相关的变量。在制定干预计划以降低再次入院风险时应考虑这些变量。
