Mizrahi E H, Fleissig Y, Arad M, Adunsky A
Department of Geriatric Medicine and Rehabilitation, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel.
Arch Gerontol Geriatr. 2006 Sep-Oct;43(2):165-73. doi: 10.1016/j.archger.2005.10.005. Epub 2005 Dec 15.
The purpose of this study was to investigate whether diabetes mellitus may affect the functional outcome of hip fractured patients. We studied 759 consecutive patients admitted for hip fracture rehabilitation, out of whom 18.2% were diabetics. The functional outcomes of diabetics and nondiabetics were assessed by the functional independence measurement scale (FIM) at admission and discharge. Data were analyzed by t-tests, Pearson correlation, and chi-square test as well as by multiple logistic regression analysis. Compared with nondiabetics, diabetic patients were slightly younger (p=0.003) and more hyperlipidemic (p=0.01), had a higher prevalence of previous stroke (p=0.03) and lower cognitive Mini-Mental State Examination (MMSE) scores (p=0.007). Absolute and relative FIM parameters, at admission and discharge, were similar in both groups. A multiple logistic regression analysis showed that diabetes was independently, and inversely, associated with male gender [odds ratio (OR), 2.11 (95% CI, 1.41-3.18)] and higher admission motor-FIM [OR, 1.05 (95% CI, 1.03-1.07)], whereas higher cognitive scores upon admission emerged as being "protective" for being in the motor-FIM gain <20 [OR, 0.94 (95% CI, 0.91-0.97)]. However, diabetes was not associated with any of the parameters indicating unsuccessful rehabilitation. The findings suggest that there is no difference in the functional outcome of diabetic and nondiabetic patients, presenting for rehabilitation after surgery of hip fractures. Diabetes should not be considered as adversely affecting rehabilitation of such patients.
本研究的目的是调查糖尿病是否会影响髋部骨折患者的功能预后。我们研究了759例连续入院接受髋部骨折康复治疗的患者，其中18.2%为糖尿病患者。通过功能独立性测量量表（FIM）在入院时和出院时评估糖尿病患者和非糖尿病患者的功能预后。数据采用t检验、Pearson相关性分析、卡方检验以及多元逻辑回归分析。与非糖尿病患者相比，糖尿病患者年龄稍小（p = 0.003），高脂血症患病率更高（p = 0.01），既往中风患病率更高（p = 0.03），认知简易精神状态检查表（MMSE）得分更低（p = 0.007）。两组在入院时和出院时的绝对和相对FIM参数相似。多元逻辑回归分析显示，糖尿病与男性性别独立且呈负相关[比值比（OR），2.11（95%可信区间，1.41 - 3.18）]以及入院时较高的运动FIM[OR，1.05（95%可信区间，1.03 - 1.07）]相关，而入院时较高的认知得分对运动FIM增益<20具有“保护作用”[OR，0.94（95%可信区间，0.91 - 0.97）]。然而，糖尿病与任何表明康复不成功的参数均无关联。研究结果表明，髋部骨折手术后接受康复治疗的糖尿病患者和非糖尿病患者在功能预后方面没有差异。糖尿病不应被视为对此类患者的康复产生不利影响。
