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髋部骨折后与死亡率和功能残疾相关的因素:一项队列起始研究。

Factors associated with mortality and functional disability after hip fracture: an inception cohort study.

作者信息

Alegre-López Javier, Cordero-Guevara José, Alonso-Valdivielso José L, Fernández-Melón Julia

机构信息

Rheumatology Department, National Institute of Health, General Yagüe Hospital, Burgos, Spain.

出版信息

Osteoporos Int. 2005 Jul;16(7):729-36. doi: 10.1007/s00198-004-1740-0. Epub 2004 Oct 30.

Abstract

Hip fracture results in excess mortality and functional disability. This study sought to identify predictors of mortality and limited functional ability 1 year after hip fracture. We conducted a 1-year follow-up of a prospective population-based inception cohort of 218 hip fracture patients who had been consecutively admitted and discharged from hospital during the previous year. Mortality was observed to be independently associated with poor mental status (relative risk [RR]=6.96; 95% confidence interval [95% CI], 1.73-28.00), prefracture limited functional ability (RR=4.35; 95% CI, 1.32-14.36), institutionalized disposition at discharge (RR = 2.92; 95% CI, 1.02-8.38), and male gender (RR = 2.44; 95% CI, 1.01-5.93). Independent predictors of limited functional ability were prefracture functional disability (RR = 34.14; 95% CI, 3.13-372.33), poor mental status (RR = 9.71; 95% CI, 1.57-59.82), age >80 years (RR = 4.03; 95% CI, 1.48-11.00), and female gender (RR = 3.57; 95% CI, 0.08-0.98). On discharge, special attention and care should thus be given to all patients displaying any of the above predictive factors.

摘要

髋部骨折会导致额外的死亡率和功能残疾。本研究旨在确定髋部骨折1年后死亡率和功能能力受限的预测因素。我们对一个基于人群的前瞻性起始队列进行了为期1年的随访,该队列包括218例髋部骨折患者,他们在上一年连续入院并出院。观察到死亡率与精神状态差(相对风险[RR]=6.96;95%置信区间[95%CI],1.73 - 28.00)、骨折前功能能力受限(RR=4.35;95%CI,1.32 - 14.36)、出院时入住机构(RR = 2.92;95%CI,1.02 - 8.38)以及男性性别(RR = 2.44;95%CI,1.01 - 5.93)独立相关。功能能力受限的独立预测因素为骨折前功能残疾(RR = 34.14;95%CI,3.13 - 372.33)、精神状态差(RR = 9.71;95%CI,1.57 - 59.82)、年龄>80岁(RR = 4.03;95%CI,1.48 - 11.00)以及女性性别(RR = 3.57;95%CI,0.08 - 0.98)。因此,出院时应特别关注所有表现出上述任何预测因素的患者,并给予护理。

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