Frenkel Rutenberg Tal, Daglan Efrat, Heller Snir, Velkes Steven
Orthopedic Department, Rabin Medical Center, Beilinson Hospital, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Orthopedic Department, Wolfson Hospital, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Injury. 2017 Jul;48(7):1584-1588. doi: 10.1016/j.injury.2017.04.049. Epub 2017 Apr 25.
Hip fractures in the elderly are a major cause of morbidity and mortality. The treatment settings of these patients may change their outcomes. The aim of this study is to compare the outcomes of patients with displaced femoral neck fractures who were admitted to the orthopedic vs. geriatric wards.
A retrospective study was conducted on 217 consecutive older patients with 219 displaced femoral neck fractures admitted either to the orthopedic or the geriatric ward between Jan. 2013 and Jun. 2015. Information regarding demographic, medical history, surgical management, hospitalization, and one year readmissions and mortality data was retrieved from electronic charts.
102 hemiarthroplasty patients were admitted to the orthopedic ward and 117 to the geriatric ward. Patients' characteristics, including age, living arrangements, mobility status and the Charlson Comorbidity Index were similar between groups. Patients from the orthopedic ward had shorter hospitalization time (9±5.1 vs. 10.8±6.7days, p=0.022) and presented a lower in-hospital complication rates (0.6±0.96 vs. 1±1.9, p=0.022), namely fewer events of urinary retentions, urinary tract infections and pneumonias (8.8% vs. 23.9%, p=0.004, 3.9% vs. 14.5%, p=0.010 and 2.9% vs. 12.2%, p=0.034, respectfully). Readmission rates were similar. Neither in hospital nor one year mortality rates differed between groups.
Our study found that geriatric care was not superior to orthopedic directed management in the treatment of elderly patients with hip fractures in terms of in-hospital complications, and hospitalization times.
老年髋部骨折是发病和死亡的主要原因。这些患者的治疗环境可能会改变其治疗结果。本研究的目的是比较入住骨科病房与老年病房的股骨颈移位骨折患者的治疗结果。
对2013年1月至2015年6月期间连续收治的217例年龄较大的患者的219例股骨颈移位骨折进行了回顾性研究。这些患者分别入住骨科或老年病房。从电子病历中获取了有关人口统计学、病史、手术治疗、住院情况、一年再入院率和死亡率的数据。
102例行半髋关节置换术的患者入住骨科病房，117例入住老年病房。两组患者的特征，包括年龄、生活安排、活动状态和查尔森合并症指数相似。骨科病房的患者住院时间较短（9±5.1天对10.8±6.7天，p = 0.022），住院并发症发生率较低（0.6±0.96对1±1.9，p = 0.022），即尿潴留、尿路感染和肺炎事件较少（分别为8.8%对23.9%，p = 0.004；3.9%对14.5%，p = 0.010；2.9%对12.2%，p = 0.034）。再入院率相似。两组患者的住院死亡率和一年死亡率均无差异。
我们的研究发现，在治疗老年髋部骨折患者时，老年护理在住院并发症和住院时间方面并不优于骨科指导管理。
