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老年跨学科家庭康复对髋部骨折后并发症和再入院的影响:一项随机对照试验。

Effects of geriatric interdisciplinary home rehabilitation on complications and readmissions after hip fracture: a randomized controlled trial.

机构信息

1 Geriatric Medicine, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.

2 Physiotherapy, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.

出版信息

Clin Rehabil. 2019 Jan;33(1):64-73. doi: 10.1177/0269215518791003. Epub 2018 Aug 1.

Abstract

OBJECTIVE

: This pre-planned secondary analysis of geriatric interdisciplinary home rehabilitation, which was initially found to shorten the postoperative length of stay in hospital for older individuals following hip fracture, investigated whether such rehabilitation reduced the numbers of complications, readmissions, and total days spent in hospital after discharge during a 12-month follow-up period compared with conventional geriatric care and rehabilitation.

DESIGN

: Randomized controlled trial.

SETTING

: Geriatric department, participants' residential care facilities, and ordinary housing.

SUBJECTS

: Individuals aged ⩾70 years with acute hip fracture ( n = 205) were included.

INTERVENTION

: Geriatric interdisciplinary home rehabilitation was individually designed and aimed at early discharge with the intention to prevent, detect, and treat complications after discharge.

MAIN MEASURES

: Complications, readmissions, and days spent in hospital were registered from patients' digital records and interviews conducted during hospitalization and at 3- and 12-month follow-up visits.

RESULTS

: No significant difference in outcomes was observed. Between discharge and the 12-month follow-up, among participants in the geriatric interdisciplinary home rehabilitation group ( n = 106) and control group ( n = 93), 57 (53.8%) and 44 (47.3%) had complications ( P = 0.443), 46 (43.4%) and 38 (40.9%) fell ( P = 0.828), and 38 (35.8%) and 27 (29.0%) were readmitted to hospital ( P = 0.383); the median total days spent in hospital were 11.5 and 11.0 ( P = 0.353), respectively.

CONCLUSION

: Geriatric interdisciplinary home rehabilitation for older individuals following hip fracture resulted in similar proportions of complications, readmissions, and total days spent in hospital after discharge compared with conventional geriatric care and rehabilitation.

摘要

目的

本研究对老年跨学科家庭康复进行了预先计划的二次分析,最初发现该康复可缩短老年髋部骨折患者的术后住院时间,本次研究旨在调查与传统老年护理和康复相比,这种康复是否在 12 个月的随访期间减少了并发症、再入院和出院后住院总天数。

设计

随机对照试验。

地点

老年科、参与者的居住护理设施和普通住宅。

受试者

年龄 ⩾70 岁、急性髋部骨折的个体(n=205)。

干预措施

老年跨学科家庭康复是根据个人情况设计的,目的是预防、发现和治疗出院后的并发症。

主要观察指标

并发症、再入院和住院天数均从患者的数字记录和住院期间以及 3 个月和 12 个月随访期间的访谈中登记。

结果

未观察到结局的显著差异。在出院和 12 个月随访期间,老年跨学科家庭康复组(n=106)和对照组(n=93)参与者中,57(53.8%)和 44(47.3%)发生并发症(P=0.443),46(43.4%)和 38(40.9%)跌倒(P=0.828),38(35.8%)和 27(29.0%)再次入院(P=0.383);住院总天数中位数分别为 11.5 和 11.0(P=0.353)。

结论

与传统老年护理和康复相比,老年髋部骨折患者的老年跨学科家庭康复导致出院后并发症、再入院和总住院天数的比例相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4eb/6311618/cd57f49a8f3a/10.1177_0269215518791003-fig1.jpg

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