Lübbeke Anne, Stern Richard, Grab Bernard, Herrmann François, Michel Jean-Pierre, Hoffmeyer Pierre
Service de chirurgie orthopédique et traumatologie de l'appareil moteur, Hôpital Cantonal Universitaire de Genève, Geneva, Switzerland.
Aging Clin Exp Res. 2005 Aug;17(4):276-80. doi: 10.1007/BF03324610.
While hip fractures represent the most dramatic consequence of osteoporosis, fractures of the humerus, forearm and wrist account for one-third of the total incidence of fractures due to osteoporosis in the older population. The aim of this retrospective cohort study was to evaluate rehabilitation care utilization and associated factors in elderly individuals with upper limb fracture.
Over two years, 667 patients 65 years of age or older were studied, who presented to the emergency department either from their private homes or nursing homes with an upper extremity fracture. The following outcome variables were collected: gender; age; residence; location of fracture; treatment; discharge destination; length of hospitalization; length of stay in a rehabilitation facility; and ultimate place of habitation after the event.
The most frequent sites of fracture were distal radius (37.2%) and proximal humerus (29.1%). Two-thirds of the patients were treated non-operatively. Inpatient rehabilitation care was necessary for 248 patients (37.2%; length of stay, 46 days). Factors associated with increased care included older age (> or = 80 years), coming from private home, sustaining two fractures, fractures of the humerus, and operative treatment. Six percent of the patients required permanent nursing home care.
Upper extremity fractures in older people often require prolonged hospitalization and therefore account for considerable health care costs. Reasons are more related to advanced age and living conditions than to particular injury or treatment.
虽然髋部骨折是骨质疏松症最严重的后果，但肱骨、前臂和腕部骨折占老年人群骨质疏松性骨折总发病率的三分之一。这项回顾性队列研究的目的是评估老年上肢骨折患者的康复护理利用情况及相关因素。
在两年多的时间里，对667名65岁及以上的患者进行了研究，这些患者从私人住宅或养老院因上肢骨折就诊于急诊科。收集了以下结局变量：性别；年龄；居住地；骨折部位；治疗方式；出院目的地；住院时间；在康复机构的停留时间；以及事件发生后的最终居住地点。
最常见的骨折部位是桡骨远端（37.2%）和肱骨近端（29.1%）。三分之二的患者接受了非手术治疗。248名患者（37.2%；住院时间46天）需要住院康复护理。与护理增加相关的因素包括年龄较大（≥80岁）、来自私人住宅、发生两处骨折、肱骨骨折以及手术治疗。6%的患者需要长期入住养老院护理。
老年人上肢骨折往往需要延长住院时间，因此产生相当可观的医疗费用。原因更多地与高龄和生活条件有关，而非特定的损伤或治疗。
