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下肢血运重建性大截肢后返回家中:荷兰的一项多中心观察性研究。

Return home after dysvascular major amputation of the lower limb: A multicentre observational study in the Netherlands.

机构信息

Rehabilitation Medicine, University Medical Center Groningen, , NL-9700RB Groningen, The Netherlands.

出版信息

J Rehabil Med. 2020 Jan 2;52(1):jrm00008. doi: 10.2340/16501977-2631.

Abstract

OBJECTIVE

To report the rates of persons returning home within one year following dysvascular major amputation of the lower limb in the Netherlands, and to identify factors associated with returning home directly after hospital admission and after discharge to care facilities.

DESIGN

Retrospective cohort study.

PATIENTS

Dysvascular major amputation of the lower limb, n = 382, mean age 71.9 years (standard deviation (SD) 12.5 years), 65% male.

METHODS

Medical records of all persons undergoing major amputation of the lower limb in 2012-2013 in 12 hospitals in Northern Netherlands were reviewed. Odds ratios (OR) were calculated using multivariate logistic regression.

RESULTS

Among persons admitted from home and surviving the hospital admission, 21% returned home, with higher odds of returning home being associated with living with a partner (OR = 2.8, p = 0.006) and younger age (< 65 years). Among those discharged to care and surviving the first year, 77% returned home within one year after amputation, with higher odds being associated with younger age (<75 years) and admission to inpatient rehabilitation (OR = 10.6, p = 0.004) or geriatric rehabilitation in skilled nursing facilities (OR = 3.5, p = 0.030).

CONCLUSION

Four out of 5 persons surviving dysvascular major amputation of the lower limb return home within one year, although a majority requires care in either inpatient rehabilitation or a skilled nursing facilities setting.

摘要

目的

报告在荷兰下肢血运性大截肢术后一年内返回家中的人数,并确定与直接入院后和出院后返回家庭相关的因素。

设计

回顾性队列研究。

患者

下肢血运性大截肢,n=382,平均年龄 71.9 岁(标准差 12.5 岁),65%为男性。

方法

回顾了 2012-2013 年在荷兰北部 12 家医院接受下肢大截肢的所有患者的病历。使用多变量逻辑回归计算了比值比(OR)。

结果

在从家中入院并存活的患者中,有 21%返回家中,与返回家中的更高几率相关的因素包括与伴侣同住(OR=2.8,p=0.006)和年龄较小(<65 岁)。在出院到护理机构并存活第一年的患者中,有 77%在截肢后一年内返回家中,与返回家中的更高几率相关的因素包括年龄较小(<75 岁)和入院接受住院康复治疗(OR=10.6,p=0.004)或在熟练护理设施中接受老年康复治疗(OR=3.5,p=0.030)。

结论

尽管大多数患者需要在住院康复或熟练护理机构中接受护理,但在下肢血运性大截肢术后一年内,有 5 人中有 4 人能够返回家中。

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