Servicio de Cirugía Ortopédica y Traumatológica, Hospital Universitari Vall d'Hebron, Barcelona, España.
Servicio de Cirugía Ortopédica y Traumatológica, Hospital Universitari Vall d'Hebron, Barcelona, España.
Med Clin (Barc). 2019 Dec 27;153(12):446-453. doi: 10.1016/j.medcli.2019.02.026. Epub 2019 Jul 16.
Hip fracture is a common injury among elderly patients. The main goal of our study was to assess the effectiveness of a multidisciplinary educational intervention aimed at hip fracture patients to promote home discharges and reduce in-hospital complications.
A quasi-experimental study was performed by taking repeated measurements at hospital admission, at hospital discharge, and at both 30days and one year of discharge. Patients aged ≥65years with hip fracture who were admitted to the Orthogeriatric Service between February 2016 and January 2017 were included in the study. The educational intervention consisted in two coordinated actions: patient education administered during their hospitalization and multimodal support provided during their discharge home.
A total of 67 patients were included in the study (77.6% of whom were women; 84.19±7,78 years old). Of these, 70.1% were discharged home, which doubles the figures recorded in the 2014-2015 period. The rate of readmission at 30days and one year of the discharge was 8.5%. At the one-year follow-up, the patient's dependence to perform basic activities of daily living was nearer to the pre-fracture level (Barthel: 86.67±19.31; 94.33±14.66), their mobility had improved in comparison with the time of discharge (Parker: 4.73±1.84; 6.73±2.76; Timed Up and Go Test: 38.29±21.27; 21.91±10.97), and their cognitive function had not worsened significantly. The patient education measures improved the patients' autonomy as perceived by the patients, the caregivers, and the healthcare providers. Satisfaction with the healthcare received was high.
As a novelty to the already described benefits in orthogeriatric care models, this study would contribute by proving an increase of the number of patients discharged home in a safe condition.
髋部骨折是老年患者常见的损伤。我们研究的主要目的是评估一项针对髋部骨折患者的多学科教育干预措施的有效性，以促进患者出院并减少院内并发症。
通过在入院时、出院时以及出院后 30 天和 1 年进行重复测量，进行了一项准实验研究。该研究纳入了 2016 年 2 月至 2017 年 1 月期间入住骨科老年病房的年龄≥65 岁、有髋部骨折的患者。教育干预包括两个协调的行动：患者在住院期间接受教育，以及在出院回家时提供多模式支持。
共有 67 例患者纳入研究（其中 77.6%为女性；84.19±7.78 岁）。其中，70.1%出院回家，这是 2014-2015 年期间记录的数字的两倍。出院后 30 天和 1 年的再入院率为 8.5%。在 1 年随访时，患者进行基本日常生活活动的自理能力更接近骨折前的水平（巴氏指数：86.67±19.31；94.33±14.66），与出院时相比，其活动能力有所改善（帕克评分：4.73±1.84；6.73±2.76；计时起立行走测试：38.29±21.27；21.91±10.97），认知功能也没有明显恶化。患者教育措施提高了患者、护理人员和医护人员对患者自主性的感知。对所接受的医疗保健的满意度很高。
除了已经描述的在骨科老年护理模式中的益处外，本研究还通过证明更多的患者能够安全出院，从而提供了新的证据。
