Lieberman Devora, Friger Michael, Lieberman David
The Department of Geriatrics, Soroka University Medical Center, Beer-Sheva, Israel.
Disabil Rehabil. 2007 Feb 28;29(4):339-45. doi: 10.1080/09638280600834542.
To characterize the course and outcome of rehabilitation following hip fracture (HF) in elderly diabetic patients.
A non-interventional prospective cohort study of 224 elderly diabetic patients who were hospitalized for rehabilitation, compared to 738 non-diabetic patients. Stepwise multiple regression was used to assess the relative contribution of the variables to the variance of the rehabilitation outcome.
The absolute efficacy of rehabilitation was lower in diabetics vs. non-diabetics (28.8 +/- 20.0 vs. 31.8 +/- 18.4, respectively, p = 0.04). This difference was caused by a significantly lower pre-event Functional Independence Measure (FIM) (112 +/- 17 vs. 115 +/- 14, p = 0.002) and a significantly higher rate of prior stroke with motor impairment (16% vs. 7%, p < 0.0001). No significant difference was found between the study groups for various rehabilitation-related complications, including mortality. None of the 12 specific variables associated with diabetes or its complications was significantly and independently associated with the outcome of rehabilitation among diabetics.
The outcome of rehabilitation in elderly diabetic patients following HF is significantly worse than in non-diabetics. This result stems from the poor pre-event functional state of these patients. The results of this study can help to predict the outcome of rehabilitation in elderly diabetic patients who are candidates for rehabilitation following surgical repair of HF.
描述老年糖尿病患者髋部骨折（HF）后康复的过程及结果。
一项针对224名因康复住院的老年糖尿病患者的非干预性前瞻性队列研究，并与738名非糖尿病患者进行比较。采用逐步多元回归评估各变量对康复结果方差的相对贡献。
糖尿病患者康复的绝对疗效低于非糖尿病患者（分别为28.8±20.0和31.8±18.4，p = 0.04）。这种差异是由事件前功能独立性测量（FIM）显著较低（112±17对115±14，p = 0.002）以及既往有运动障碍的中风发生率显著较高（16%对7%，p < 0.0001）所致。在包括死亡率在内的各种与康复相关的并发症方面，研究组之间未发现显著差异。与糖尿病或其并发症相关的12个特定变量中，没有一个与糖尿病患者的康复结果显著且独立相关。
老年糖尿病患者髋部骨折后的康复结果明显比非糖尿病患者差。这一结果源于这些患者事件前的功能状态较差。本研究结果有助于预测老年糖尿病患者髋部骨折手术修复后适合康复的患者的康复结果。
