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在快速康复计划下,大多数患者在髋部骨折手术后恢复到骨折前的基本活动能力。

Most patients regain prefracture basic mobility after hip fracture surgery in a fast-track programme.

作者信息

Kristensen Morten Tange, Kehlet Henrik

机构信息

Fysioterapien og Ortopædkirurgisk Afdeling, Hvidovre Hospital, 2650 Hvidovre, Denmark.

出版信息

Dan Med J. 2012 Jun;59(6):A4447.

Abstract

INTRODUCTION

Treatment of patients with hip fracture has improved over the past decade. Still, some patients do not regain independent mobility within their primary hospital stay even if they follow a multimodal fast-track surgical programme. The aim of the present article was to examine the validity of the preliminary prefracture New Mobility Score (NMS), age and fracture type as independent predictors of in-hospital outcome after hip fracture surgery.

MATERIAL AND METHODS

The study comprised a total of 213 consecutive patients with a median age of 82 years who were admitted from their own home to a special hip fracture unit. Outcome variables were the regain of independency in basic mobility as evaluated by the Cumulated Ambulation Score, and discharge destination in the community.

RESULTS

Multiple logistic regression analysis revealed that patients with a low prefracture NMS and/or an intertrochanteric fracture were 6.5 and four times more likely to not regain independency in basic mobility during admittance than patients with a high prefracture NMS level and a cervical fracture, respectively. In addition, the odds of not regaining independent mobility increased with age by 5% per year. The same three variables significantly increased the odds of patients not being discharged to their own home.

CONCLUSION

Prefracture NMS, age and fracture type were confirmed as independent predictors of in-hospital outcome in patients with hip fracture who followed a multimodal rehabilitation concept.

摘要

引言

在过去十年中,髋部骨折患者的治疗有所改善。然而,即使一些患者遵循多模式快速康复手术方案,在其首次住院期间仍未能恢复独立活动能力。本文的目的是检验骨折前初步新活动能力评分(NMS)、年龄和骨折类型作为髋部骨折手术后住院结局独立预测因素的有效性。

材料与方法

该研究共纳入213例连续患者,他们均从家中被收治到一个专门的髋部骨折治疗单元,中位年龄为82岁。结局变量包括通过累积步行评分评估的基本活动能力恢复情况以及社区出院目的地。

结果

多因素逻辑回归分析显示,骨折前NMS较低和/或转子间骨折的患者在入院期间未能恢复基本活动能力的可能性分别是骨折前NMS水平较高且为颈椎骨折患者的6.5倍和4倍。此外,未能恢复独立活动能力的几率每年随年龄增长5%。同样的三个变量显著增加了患者未出院回家的几率。

结论

在遵循多模式康复理念的髋部骨折患者中,骨折前NMS、年龄和骨折类型被确认为住院结局的独立预测因素。

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