Laamanen R, Kekki P, Lillqvist G
Vard Nord Utveckl Forsk. 1992 Spring;12(1):8-13. doi: 10.1177/010740839201200103.
The purpose of the present study was to determine the variables associated with the length of hospital stay and to evaluate the ability to reach prefracture ADL-status after operation on patients with proximal fractures of femur. One hundred patients with cervical and trochanteric fracture were operated with internal fixation and endoprosthesis during a two year period. The type of surgical procedure selection was made by the surgeons own decision as part of treatment routine. The data were collected using a structured interview, participating observation and content analysis. The follow-up period was six months. The mean hospitalization time was 31.5 days, when seven patients with extremely long hospitalization, due to waiting for a long term care, were excluded. Stepwise regression analysis was used to determine variables associated with a longer hospital stay. Variables that related to poor prognosis were age, sex of patient, operation delay, weightbearing, medication, dizziness, status post paralysis and circumstances of dwelling. A significant difference was found between internal fixation and endoprosthesis at patient with cervical fracture of femur regarding to the length of hospital stay and ability to reach prefracture ADL-status in two weeks after operation. Results of this study showed, that the objective, to discharge patients in two or three weeks, was not achieved. This study also showed, that all patients did not regain the prefracture ADL-status during a follow-up period. It is important to assure the effectiveness of treatment after discharge from hospital in primary care and to prevent proximal fractures of femur in the elderly.
本研究的目的是确定与住院时间相关的变量,并评估股骨近端骨折患者术后达到骨折前日常生活活动(ADL)状态的能力。在两年期间,对100例颈椎和转子间骨折患者进行了内固定和假体植入手术。手术方式的选择由外科医生根据治疗常规自行决定。通过结构化访谈、参与观察和内容分析收集数据。随访期为6个月。排除7例因等待长期护理而住院时间极长的患者后,平均住院时间为31.5天。采用逐步回归分析确定与较长住院时间相关的变量。与预后不良相关的变量包括年龄、患者性别、手术延迟、负重、用药、头晕、瘫痪后状态和居住环境。在股骨颈骨折患者中,内固定和假体植入在住院时间以及术后两周内达到骨折前ADL状态的能力方面存在显著差异。本研究结果表明,在两到三周内让患者出院的目标未实现。本研究还表明,并非所有患者在随访期间都恢复到了骨折前的ADL状态。确保出院后初级保健中治疗的有效性以及预防老年人股骨近端骨折非常重要。