Department for Healthcare of Older People, Queens Medical Centre, Nottingham University Hospital NHS Trust, Derby Road, Nottingham, NG7 2UH, UK.
Division of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Nottingham, UK.
Osteoporos Int. 2020 Feb;31(2):363-370. doi: 10.1007/s00198-019-05198-x. Epub 2019 Nov 6.
Patients hospitalised with vertebral fragility fractures were elderly, multimorbid and frail and lead to poor outcomes. Their hospital treatment needs to consider this alongside their acute fracture. A systematic organised model of care, such as an adaptation of orthogeriatric hip fracture care, will offer a more holistic approach potentially improving their outcomes.
Patients admitted to hospital with vertebral fragility fractures are elderly and have complex care needs who may benefit from specialist multidisciplinary input. To date, their characteristics and outcomes have not been reported sufficiently. This study aims to justify such a service.
Patients admitted with an acute vertebral fragility fracture over 12 months were prospectively recruited from a university hospital in England. Data were collected soon after their admission, at discharge from hospital and 6 months after their hospital discharge on their characteristics, pain, physical functioning, and clinical outcomes.
Data from 90 participants were analysed. They were mainly elderly (mean age 79.7 years), multimorbid (69% had ≥ 3 comorbid condition), frail (56% had a Clinical Frailty Scale score ≥ 5), cognitively impaired (54% had a MoCA score of < 23) and at high risk of falls (65% had fallen ≥ 2 in the previous year). Eighteen percent died at 6 months. At 6 months post-hospital discharge, 12% required a new care home admission, 37% still reported their pain to be severe and physical functioning was worse compared with their preadmission state.
Patients hospitalised with vertebral fragility fractures were elderly, multimorbid, frail and are susceptible to persistent pain and disability. Their treatment in hospital needs to consider this alongside their acute fracture. A systematic organised model of care, such as an adaptation of orthogeriatric hip fracture care, will offer a more holistic approach potentially improving their outcomes.
因椎体脆性骨折住院的患者年龄较大，多病且身体虚弱，导致预后较差。他们的住院治疗需要考虑到急性骨折和这些合并症。系统的有组织的护理模式，如骨科髋部骨折护理的改编，将提供更全面的治疗方法，有可能改善他们的预后。
因急性椎体脆性骨折住院的患者年龄较大，且有复杂的护理需求，可能受益于多学科专家的介入。迄今为止，他们的特征和结局尚未得到充分报道。本研究旨在证实这种服务的合理性。
在英格兰的一所大学医院，前瞻性地招募了 12 个月内因急性椎体脆性骨折入院的患者。在他们入院后、出院时和出院后 6 个月，收集了他们的特征、疼痛、身体功能和临床结局的数据。
分析了 90 名参与者的数据。他们主要是老年人（平均年龄 79.7 岁），多病（69%有≥3 种合并症），身体虚弱（56%的临床虚弱量表评分为≥5），认知障碍（54%的 MoCA 评分为<23），且易跌倒（65%在过去一年中跌倒≥2 次）。18%的患者在 6 个月时死亡。出院后 6 个月，12%的患者需要新入住养老院，37%的患者仍报告疼痛严重，身体功能较入院前更差。
因椎体脆性骨折住院的患者年龄较大，多病，身体虚弱，易发生持续性疼痛和残疾。他们在医院的治疗需要考虑到急性骨折和这些合并症。系统的有组织的护理模式，如骨科髋部骨折护理的改编，将提供更全面的治疗方法，有可能改善他们的预后。
