Beit Rivka Geriatric Rehabilitation Center, Petach Tikva, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Beit Rivka Geriatric Rehabilitation Center, Petach Tikva, Israel.
Arch Gerontol Geriatr. 2020 Jul-Aug;89:104070. doi: 10.1016/j.archger.2020.104070. Epub 2020 Apr 20.
The assessment of immediate functional change after hip fracture surgery may assist in predicting rehabilitation outcome and improve program efficiency.
To evaluate the potential of the initial functional recovery measure in predicting rehabilitation outcome of hip fractured patients.
Retrospective cohort study.
Post-acute geriatric rehabilitation center.
A total of 630 hip fractured patients admitted from 1/2016-6/2019.
The initial functional recovery, a measure of functional change from the time of surgery to rehabilitation was calculated for each patient. The association between initial functional recovery and clinical and demographic variables was assessed by the Mann-Whitney and chi-square tests. A multiple linear regression model evaluated the association between initial functional recovery and the discharge functional independence measure score. Regression analysis estimated the association between initial functional recovery and the achievement of a favorable outcome measure.
A good correlations were found between initial functional recovery and rehabilitation outcomes but not length of stay (p < 0.001). Multiple linear regression analysis showed that after adjustment for potential confounding variables, the higher the initial functional recovery, the better the discharge functional independence measure score (r = 0.783; p < 0.001). Logistic regression revealed that a high initial functional recovery was significantly associated with a higher probability of achieving a favorable functional gain (OR = 1.093; 95% CI = 1.04-1.15, P < 0.001).
Initial functional recovery is a good predictor of rehabilitation outcomes in hip fractured patients, and may be utilized in decision-making regarding the rehabilitation program in addition to coordinating expectations with patients and their caregivers.
评估髋部骨折手术后的即时功能变化有助于预测康复结局并提高方案效率。
评估初始功能恢复测量值预测髋部骨折患者康复结局的潜力。
回顾性队列研究。
急性后期老年康复中心。
共纳入 630 例 2016 年 1 月至 2019 年 6 月期间因髋部骨折入院的患者。
计算每位患者从手术到康复的初始功能恢复情况，即功能变化的衡量指标。采用 Mann-Whitney 和卡方检验评估初始功能恢复与临床和人口统计学变量之间的关系。采用多元线性回归模型评估初始功能恢复与出院功能独立性测量评分之间的关系。回归分析估计初始功能恢复与实现有利结局测量之间的关系。
初始功能恢复与康复结局之间存在较好的相关性，但与住院时间无关（p < 0.001）。多元线性回归分析显示，在校正潜在混杂变量后，初始功能恢复越高，出院功能独立性测量评分越好（r = 0.783；p < 0.001）。逻辑回归显示，较高的初始功能恢复与实现有利的功能增益的概率更高显著相关（OR = 1.093；95% CI = 1.04-1.15，P < 0.001）。
初始功能恢复是髋部骨折患者康复结局的良好预测指标，除了与患者及其护理人员协调期望外，还可用于制定康复方案。
