Zuckerman J D, Sakales S R, Fabian D R, Frankel V H
Hospital for Joint Disease, Orthopaedic Institute, New York, New York 10003.
Clin Orthop Relat Res. 1992 Jan(274):213-25.
The care of geriatric patients who sustain hip fractures is difficult because of associated medical comorbidities, the risk of medical and surgical complications, and the functional limitations that are often present before the fracture. The authors developed and used a comprehensive, interdisciplinary care program that has so far treated 431 geriatric hip fracture patients. The results of the program group were compared to a matched nonprogram group of patients (n = 60) cared for before the initiation of the program (and before the initiation of diagnosis-related groups). The program patients had fewer postoperative complications, significantly fewer (p less than .05) intensive care unit transfers (10.2% versus 20%), significantly improved (p less than .001) ambulatory ability at discharge (56.3% independent with assistive devices versus 18.2%), and proportionately fewer discharges to nursing homes (8.1% versus 19.3%). These results support the use of an interdisciplinary approach as a means of improving the inhospital care of geriatric hip fracture patients.
由于存在相关的内科合并症、内科及外科并发症风险以及骨折前常出现的功能受限，老年髋部骨折患者的护理工作颇具难度。作者制定并采用了一项全面的跨学科护理计划，该计划迄今已治疗了431例老年髋部骨折患者。将该计划组的结果与在计划启动之前（以及诊断相关分组启动之前）接受护理的匹配非计划组患者（n = 60）进行比较。计划组患者术后并发症更少，重症监护病房转科率显著更低（p < 0.05）（10.2% 对20%），出院时的行走能力显著改善（p < 0.001）（使用辅助器械时56.3% 能够独立行走对18.2%），入住养老院的出院患者比例也相应更低（8.1% 对19.3%）。这些结果支持采用跨学科方法作为改善老年髋部骨折患者住院护理的一种手段。
