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髋部骨折成人患者中,无论是否存在髋部骨折前痴呆,康复期间认知能力的提高与功能结局之间的关系。

The relation between gain in cognition during rehabilitation on functional outcome among hip fracture adult patients with and without pre- hip fracture dementia.

机构信息

Department of Geriatric Medicine and Rehabilitation, Shmuel Harofeh Hospital, Beer Yaakov Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

Department of Computer Science, HIT - Holon Institute of Technology, Israel.

出版信息

Arch Gerontol Geriatr. 2018 Sep-Oct;78:177-180. doi: 10.1016/j.archger.2018.06.016. Epub 2018 Jun 30.

Abstract

The purpose of the present study was focused on the relationship between change in cognition and the functional outcome during rehabilitation in demented and non-demented adult hip fracture patients. We studied seventy consecutive adult patients with hip fracture admitted to our rehabilitation wards. Functional outcome was assessed by the Functional Independence Measure (FIM). The gain in cognition during the rehabilitation process was measured by the difference in Mini Mental State Examination scores at admission and discharge. Data was analyzed by t-test, chi square-test and linear regression. Patients without dementia presented and discharged from the rehabilitation ward with statistically significant higher total, motor, and gain functional independence measure scores compared to patients with dementia. In a multiple regression analyses, gain in Mini Mental State scores examination were not independently associated with higher total and motor functional independence measure scores at discharge (beta = 0.086, p = 0.194; beta = 0.077, p = 0.309, respectively). Our findings suggest that there is no association between functional outcome and cognitive gain at the end of the rehabilitation process among adult hip fracture patients with and without dementia. However hip fracture adult patients with dementia should not be deprived of a post-acute rehabilitation.

摘要

本研究旨在探讨认知变化与痴呆和非痴呆成年髋部骨折患者康复期间功能结局之间的关系。我们研究了 70 例连续收治的髋部骨折成年患者,他们被收入我院康复病房。采用功能独立性测量(FIM)评估功能结局。通过入院和出院时简易精神状态检查(MMSE)评分的差值来衡量康复过程中的认知增益。采用 t 检验、卡方检验和线性回归进行数据分析。与痴呆患者相比,无痴呆症的患者在康复病房入院和出院时的总、运动和获得的功能独立性测量评分均显著更高。在多元回归分析中,MMSE 评分的增益与出院时总功能独立性测量和运动功能独立性测量评分的升高无关(β=0.086,p=0.194;β=0.077,p=0.309)。我们的研究结果表明,痴呆和非痴呆成年髋部骨折患者在康复结束时,功能结局与认知增益之间没有关联。然而,痴呆的髋部骨折成年患者不应被剥夺急性后康复的机会。

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