Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
AJNR Am J Neuroradiol. 2011 Oct;32(9):1614-6. doi: 10.3174/ajnr.A2580. Epub 2011 Aug 4.
A variety of factors, such as pain level at rest and with activity, have been used to assess outcome of the VP procedure. However, few studies have assessed discharge disposition as a reflection of VP efficacy in the inpatient population. The purpose of this study was to compare patient disposition status before and after VP and determine what relationship exists between the treatment and patient discharge status.
We performed a retrospective review of inpatients who underwent consultation for consideration of spinal augmentation for treatment of painful vertebral compression fractures. We gathered data concerning patients' demographics, living arrangements before hospitalization, discharge disposition, quantitative and qualitative pain levels, and length of hospital stay before and following VP.
Ninety inpatients underwent VP, 73 (81%) of whom lived independently at home before hospitalization. Of these 73 patients, 31 (42%) returned home after discharge, 9 (12%) returned home with home health care assistance, and 32 (44%) were sent to skilled nursing facilities. Six (7%) of the 90 patients resided in assisted-living centers before hospitalization; all of these patients were discharged to assisted-living or skilled nursing facilities. Eight (9%) of the 90 patients resided at skilled nursing centers before hospitalization, and all returned to nursing centers after their hospital stay. Discharge disposition was not significantly associated with preoperative pain levels at rest or with activity (P = .76 and P = .23, respectively) or with postoperative pain levels at rest or with activity (P = .08 and P = .25, respectively).
This study demonstrates that patients undergoing VP as inpatients are often discharged to rehabilitation centers rather than home, irrespective of their status before hospitalization or their pre- and postoperative pain levels.
多种因素,如静息时和活动时的疼痛程度,已被用于评估 VP 手术的结果。然而,很少有研究评估出院情况作为住院人群中 VP 疗效的反映。本研究的目的是比较 VP 前后患者的出院情况,并确定治疗与患者出院状态之间存在什么关系。
我们对因考虑脊柱增强以治疗疼痛性椎体压缩性骨折而行咨询的住院患者进行了回顾性研究。我们收集了有关患者人口统计学资料、住院前的居住安排、出院情况、定量和定性疼痛水平以及 VP 前后住院时间的数据。
90 名住院患者接受了 VP,其中 73 名(81%)在住院前独立居住在家中。在这 73 名患者中,31 名(42%)出院后返回家中,9 名(12%)出院后在家中接受家庭健康护理援助,32 名(44%)被送往熟练护理设施。90 名患者中有 6 名(7%)在住院前居住在辅助生活中心;所有这些患者都被送往辅助生活或熟练护理设施。8 名(9%)在住院前居住在熟练护理中心的患者,所有患者在住院后都返回了护理中心。出院情况与术前静息时或活动时的疼痛水平(P =.76 和 P =.23)或术后静息时或活动时的疼痛水平(P =.08 和 P =.25)均无显著相关性。
本研究表明,接受住院 VP 治疗的患者经常出院到康复中心,而不是回家,无论他们在住院前的状态如何,也无论他们的术前和术后疼痛水平如何。