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南非一家三级医院老年髋部骨折患者的住院时间及影响因素分析。

Length of stay and contributing factors in elderly patients who have undergone hip fracture surgery in a tertiary hospital in South Africa.

机构信息

Department of Nursing Science, University of Pretoria, South Africa.

Department of Nursing Science, University of Pretoria, South Africa.

出版信息

Int J Orthop Trauma Nurs. 2020 May;37:100748. doi: 10.1016/j.ijotn.2019.100748. Epub 2019 Dec 9.

Abstract

BACKGROUND

Length of stay and factors that contribute to length of stay in elderly patients who have undergone hip fracture surgery is under researched in developing countries, including South Africa. The purpose of this study was to describe the factors that increase length of stay (LOS) among elderly patients who have had hip fracture surgery.

METHODS

A retrospective review of patient records of elderly (>65 years) patients who had hip fracture surgery in a public hospital in South Africa. Descriptive statistics were used to report demographic data, LOS and frequency distributions of individual factors relating to LOS. Two sample t-tests were used to compare the LOS in patients with and without main complications reported.

RESULTS

The mean total length of stay was 33 (19) days. Patients presented with numerous comorbidities, with hypertension (n = 93) being the most prevalent. The most frequently occurring complications included anaemia (n = 42) and wound infection (n = 21). The LOS was significantly lower for patients not presenting with wound infections compared to those who sustained a wound infection (p = 0.041). Social factors delayed departure from the hospital for 48 patients.

CONCLUSION

Elderly patients who had hip fracture surgery and developed wound infections had an increased LOS. However social issues also contributed to the increase in length of stay that could be addressed by proper planning and involvement of families and care givers. The factors identified could be used as a starting point for planning services aimed at decreasing the hospital stay of elderly patients.

摘要

背景

在包括南非在内的发展中国家,对于接受髋部骨折手术的老年患者的住院时间及其影响因素的研究较少。本研究旨在描述导致髋部骨折手术老年患者住院时间延长的因素。

方法

对南非一家公立医院接受髋部骨折手术的老年(>65 岁)患者的病历进行回顾性分析。采用描述性统计方法报告人口统计学数据、住院时间和与住院时间相关的个体因素的频率分布。采用两样本 t 检验比较报告有主要并发症和无主要并发症患者的住院时间。

结果

患者的平均总住院时间为 33(19)天。患者存在多种合并症,其中高血压(n=93)最为常见。最常见的并发症包括贫血(n=42)和伤口感染(n=21)。与发生伤口感染的患者相比,未发生伤口感染的患者的住院时间明显缩短(p=0.041)。社会因素导致 48 名患者延迟出院。

结论

髋部骨折手术并发生伤口感染的老年患者住院时间延长。然而,社会问题也导致住院时间延长,可以通过适当的规划以及家庭成员和护理人员的参与来解决。确定的这些因素可以作为规划服务的起点,旨在缩短老年患者的住院时间。

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