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髋关节骨折手术后的结果:一项为期 2 年的前瞻性研究。

Outcomes following hip fracture surgery: a 2-year prospective study.

机构信息

Faculty of Medical and Human Sciences, Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, England.

Department of Psycho-Oncology, The Christie NHS Foundation Trust, Manchester, England.

出版信息

Am J Geriatr Psychiatry. 2014 Aug;22(8):838-44. doi: 10.1016/j.jagp.2013.01.047. Epub 2013 Feb 6.

Abstract

OBJECTIVES

To describe the health outcomes in older people following hip fracture surgery.

DESIGN, SETTING, AND PARTICIPANTS: A naturalistic prospective study of people who had undergone hip fracture surgery undertaken in three specialist inpatient orthopaedic units in Manchester, England, with follow-up for 2 years in primary care. One hundred forty-two people, age 60 and older who had undergone hip fracture surgery of whom 74 were interviewed at follow-up.

MEASUREMENTS

Assessment of mood (using the Geriatric Depression Scale and Hospital Anxiety and Depression Scale), cognitive function (Mini-Mental State Examination), pain (Wong-Baker and McGill scales), tests of function (Up and Go Test, Gait Test and Functional Reach), and Sickness Impact Profile.

RESULTS

Twenty-six percent of the original group had died by the time of the 2-year follow-up and associated with increasing age, poorer mobility, and higher levels of support. Sixteen percent of the group were found to be depressed, the only robust predictor of this being depression at entry to the study. There was a consistency in the presence or absence of depressive symptoms over the duration of the study. Forty-nine percent were able to walk independently at 2 years.

CONCLUSION

The presence of depressive symptoms is associated with poor outcomes at 2 years. Few people recover from, or develop, depression over 2 years.

摘要

目的

描述老年人髋部骨折手术后的健康结果。

设计、地点和参与者:这是一项在英国曼彻斯特的三个专业住院骨科病房进行的自然前瞻性研究,对髋部骨折手术的患者进行了为期 2 年的初级保健随访。共有 142 名年龄在 60 岁及以上的患者接受了髋部骨折手术,其中 74 名在随访时接受了采访。

测量

评估情绪(使用老年抑郁量表和医院焦虑抑郁量表)、认知功能(简易精神状态检查)、疼痛(Wong-Baker 和 McGill 量表)、功能测试(Up and Go 测试、步态测试和功能伸展)和疾病影响量表。

结果

在 2 年随访时,原始组中有 26%的患者已经死亡,这与年龄的增长、移动能力的下降和更高水平的支持有关。16%的患者被发现患有抑郁症,唯一可靠的预测因素是进入研究时的抑郁。在研究期间,抑郁症状的存在或不存在具有一致性。49%的人在 2 年内能够独立行走。

结论

抑郁症状的存在与 2 年后的不良结局有关。很少有人在 2 年内从抑郁中恢复或发展为抑郁。

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