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髋关节骨折后 3 个月在家中生活的患者自评功能和感知健康的预后因素。

Prognostic factors for self-rated function and perceived health in patient living at home three months after a hip fracture.

机构信息

Department of Geriatric Medicine, Oslo University Hospital, Ullevål, N-0407 Oslo, Norway.

出版信息

Disabil Rehabil. 2012;34(14):1225-31. doi: 10.3109/09638288.2011.643333. Epub 2012 Jan 9.

Abstract

PURPOSE

To explore the relationship between prefracture sociodemographic and health characteristics, basic activities of daily living, instrumental activities of daily living and perceived health 3 months after a hip fracture aged 65 or older.

METHODS

Age, sex, living alone or not, use of walking aids and whether they had experienced another fall during the previous 6 months, were recorded in hospital and at a three-month follow-up. A total of 277 patients were included. The Barthel Index, the Nottingham Extended ADL Index, the Short Form-12 questionnaire, and the Mini Mental State Examination were used.

RESULTS

Prefracture use of a walking aid outdoors was a predictor of postfracture dependency in basic activities of daily living: odds ratio (OR) 2.0, 95% confidence intervals (CI 1.1-3.6), reduced score in instrumental activities of daily living (OR 1.8; 95% CI 1.0-3.2) and reduced perceived physical health (p = 0.04). Prefracture instrumental activity of daily living was a predictor for dependency in basic activities of daily living (OR 3.3; 95% CI 1.7-6.3). Cognitive dysfunction was a risk factor for dependency in basic activities of daily living (OR 0.1; 95% CI 0.01-0.7).

CONCLUSIONS

Prefracture use of outdoor walking aids, perceived physical health, cognitive function, instrumental activity of daily living and female gender were all predictors explaining the three-month outcomes for basic activities of daily living and instrumental activity of daily living.

摘要

目的

探讨 65 岁及以上髋部骨折后 3 个月时骨折前社会人口学和健康特征、基本日常生活活动、工具性日常生活活动和感知健康之间的关系。

方法

在住院期间和 3 个月随访时记录年龄、性别、是否独居、是否使用助行器以及是否在过去 6 个月内再次跌倒。共纳入 277 例患者。使用巴氏量表、诺丁汉扩展日常生活活动指数、简明健康状况调查问卷和简易精神状态检查。

结果

骨折前户外使用助行器是骨折后基本日常生活活动依赖的预测因素:比值比(OR)2.0,95%置信区间(CI 1.1-3.6),工具性日常生活活动评分降低(OR 1.8;95% CI 1.0-3.2)和感知身体健康下降(p=0.04)。骨折前工具性日常生活活动是基本日常生活活动依赖的预测因素(OR 3.3;95% CI 1.7-6.3)。认知功能障碍是基本日常生活活动依赖的危险因素(OR 0.1;95% CI 0.01-0.7)。

结论

骨折前使用户外助行器、感知身体健康、认知功能、工具性日常生活活动和女性是解释基本日常生活活动和工具性日常生活活动 3 个月结局的预测因素。

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