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康复机构出院后髋部骨折患者的连续性护理。

Continuity of care for patients with hip fracture after discharge from rehabilitation facility.

作者信息

Contro Diego, Elli Sara, Castaldi SIlvana, Formili Marco, Ardoino Ilaria, Caserta Antonello Valerio, Panella Lorenzo

机构信息

School of Specialization in Physical and Rehabilitation Medicine, University of Milan.

出版信息

Acta Biomed. 2019 Sep 6;90(3):385-393. doi: 10.23750/abm.v90i3.8872.

Abstract

UNLABELLED

Background and aims of the work: Hip fracture is a dramatic event especially in the elderly and the return to the pre-fracture functional and social state is often difficult to achieve. In the post-acute, the intensive rehabilitation period aims to recover as much autonomy as possible to these patients, but not always its duration is sufficient to ensure an effective and lasting result in returning home, hence the need for additional rehabilitation services. Our aim was to evaluate the use of additional rehabilitation services by patients who underwent hip fracture after an intensive rehabilitation treatment period performed at our hospital.

METHODS

This is a retrospective cohort study. We involved patients aged 45 years and older, admitted at our intensive rehabilitation, who joined a rehabilitation program for a hip fracture.

RESULTS

Our results showed how the use of further physiotherapy is associated with the type of surgical intervention and with higher Cumulative Illness Rating Scale CIRS scores. Similarly, the loss of autonomy is associated with the type of intervention, the increase in CIRS and the duration of the physiotherapy, and negatively associated with the duration of each session. The re-hospitalizations for each cause is positively associated with CIRS and negatively associated with the further use of physiotherapy.

CONCLUSIONS

Our conclusion is that rehabilitation needs a personalized schedule, because the real discriminating factor in the management of frail patients should therefore be the quality, and not the quantity (i.e. longer session), of the rehabilitative intervention prescribed.

摘要

未标注

工作背景和目的:髋部骨折是一个严重事件,尤其在老年人中,恢复到骨折前的功能和社会状态往往难以实现。在急性后期,强化康复期旨在让这些患者尽可能恢复自主能力,但康复期的时长并不总能确保患者回家后能获得有效且持久的康复效果,因此需要额外的康复服务。我们的目的是评估在我院接受强化康复治疗后发生髋部骨折的患者对额外康复服务的使用情况。

方法

这是一项回顾性队列研究。我们纳入了45岁及以上在我院接受强化康复治疗且参加了髋部骨折康复项目的患者。

结果

我们的结果显示,进一步接受物理治疗与手术干预类型以及更高的累积疾病评定量表(CIRS)评分相关。同样,自主能力丧失与干预类型、CIRS升高以及物理治疗时长相关,且与每次治疗时长呈负相关。因各种原因再次住院与CIRS呈正相关,与进一步使用物理治疗呈负相关。

结论

我们的结论是,康复需要个性化方案,因为在体弱患者的管理中,真正起区分作用的因素应该是所规定康复干预的质量,而非数量(即更长的治疗时长)。

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