OʼHara Nathan N, Mulliken Alexandra, Joseph Katherine, Slobogean Gerard P, Johal Herman, Cunningham Brian P, Olaya Stephan, Levy Joseph, Pollak Andrew N, Klazinga Niek S
Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD.
Department of Public Health, University of Amsterdam, Amsterdam, the Netherlands.
J Orthop Trauma. 2019 Nov;33 Suppl 7:S16-S20. doi: 10.1097/BOT.0000000000001621.
To determine the recovery priorities of extremity fracture patients during the subacute phase and the patient factors associated with variation in recovery priorities.
Discrete choice experiment.
Academic trauma center.
One hundred ninety-eight patients with a fracture to the appendicular skeleton. Patients with severe traumatic brain injuries, spinal cord injuries, and non-English-speaking patients were excluded.
The relative importance of clinical recovery, work-related recovery, and obtaining disability benefits after injury.
In the subacute period, clinical recovery was the main priority for fracture patients (mean: 62%, SD: 5.3). Work-related recovery (mean: 27%, SD: 3.9) and the receipt of other disability benefits (mean: 11%, SD: 6.4) were each of significantly less importance. Heterogeneity was observed across these estimates based on the physical demands of preinjury employment, preinjury physical health, preinjury work status, health insurance type, and the severity of the fracture.
Clinical recovery was of paramount importance for fracture patients during the subacute recovery phase. However, patients also valued resuming work and access to disability benefits. Understanding a patient's recovery priorities early in the clinical care pathway will enable the development of multidisciplinary care plans that are responsive to these priorities and, hence, deliver value-based health care.
Level V. See Instructions for Authors for a complete description of levels of evidence.
确定四肢骨折患者亚急性期的康复优先事项以及与康复优先事项差异相关的患者因素。
离散选择实验。
学术创伤中心。
198例附肢骨骼骨折患者。排除严重创伤性脑损伤、脊髓损伤患者及非英语患者。
受伤后临床康复、与工作相关的康复以及获得残疾福利的相对重要性。
在亚急性期，临床康复是骨折患者的主要优先事项（均值：62%，标准差：5.3）。与工作相关的康复（均值：27%，标准差：3.9）和获得其他残疾福利（均值：11%，标准差：6.4）的重要性均显著较低。根据伤前工作的体力要求、伤前身体健康状况、伤前工作状态、健康保险类型和骨折严重程度，这些估计值存在异质性。
在亚急性康复阶段，临床康复对骨折患者至关重要。然而，患者也重视恢复工作和获得残疾福利。在临床护理路径早期了解患者的康复优先事项，将有助于制定多学科护理计划，以响应这些优先事项，从而提供基于价值的医疗服务。
V级。有关证据级别的完整描述，请参阅作者指南。
