Division of Physical Therapy, Health Sciences Center, Lund University, Sweden.
Acta Orthop. 2010 Jun;81(3):296-302. doi: 10.3109/17453674.2010.487240.
Clinicians need valid and easily applicable predictors of outcome in patients with hip fracture. Adjusting for previously established predictors, we determined the predictive value of the New Mobility score (NMS) for in-hospital outcome in patients with hip fracture.
We studied 280 patients with a median age of 81 (interquartile range 72-86) years who were admitted from their own homes to a special hip fracture unit. Main outcome was the regain of independence in basic mobility, defined as. independence in getting in and out of bed, sitting down and standing up from a chair, and walking with an appropriate walking aid. The Cumulated Ambulation score was used to evaluate basic mobility. Predictor variables were NMS functional level before fracture, age, sex, fracture type, and mental and health status.
Except for sex, all predictor variables were statistically significant in univariate testing. In multiple logistic regression analysis, only age, NMS functional level before fracture, and fracture type were significant. Thus, patients with a low prefracture NMS and/or an intertrochanteric fracture would be 18 and 4 times more likely not to regain independence in basic mobility during the hospital stay, respectively, than patients with a high prefracture level and a cervical fracture, respectively. The model was statistically stable and correctly classified 84% of cases.
The NMS functional level before fracture, age, and fracture type facilitate prediction of the in-hospital rehabilitation potential after hip fracture surgery.
临床医生需要有效的、易于应用的髋关节骨折患者预后预测指标。本研究在调整了先前建立的预测指标后,确定了新移动评分(NMS)对髋关节骨折患者住院期间预后的预测价值。
我们研究了 280 名年龄中位数为 81 岁(四分位距 72-86 岁)的患者,他们从自己的家中被收入专门的髋部骨折病房。主要结局是髋关节骨折患者在住院期间恢复基本活动能力的独立性,定义为能够独立上下床、从椅子上坐起和站立以及使用适当的助行器行走。累积活动评分用于评估基本活动能力。预测变量包括骨折前的 NMS 功能水平、年龄、性别、骨折类型以及精神和健康状况。
除性别外,所有预测变量在单变量检验中均具有统计学意义。在多因素逻辑回归分析中,只有年龄、骨折前的 NMS 功能水平和骨折类型具有统计学意义。因此,与骨折前 NMS 水平高且为股骨颈骨折的患者相比,骨折前 NMS 水平低且/或为转子间骨折的患者在住院期间不能恢复基本活动能力的可能性分别增加 18 倍和 4 倍。该模型具有统计学稳定性,正确分类了 84%的病例。
骨折前的 NMS 功能水平、年龄和骨折类型有助于预测髋关节骨折手术后住院期间的康复潜力。