Division of Geriatric Medicine, Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.
Providence Healthcare, Vancouver, British Columbia, Canada.
Gerontology. 2020;66(6):542-548. doi: 10.1159/000510903. Epub 2020 Nov 11.
Comprehensive geriatric care (CGC) for older adults during hospitalization for hip fracture can improve mobility, but it is unclear whether CGC delivered after a return to community living improves mobility compared with usual post-discharge care.
To determine if an outpatient clinic-based CGC regime in the first year after hip fracture improved mobility performance at 12 months.
A two-arm, 1:1 parallel group, pragmatic, single-blind, single-center, randomized controlled trial at 3 hospitals in Vancouver, BC, Canada. Participants were community-dwelling adults, aged ≥65 years, with a hip fracture in the previous 3-12 months, who had no dementia and walked ≥10 m before the fracture occurred. Target enrollment was 130 participants. Clinic-based CGC was delivered by a geriatrician, physiotherapist, and occupational therapist. Primary outcome was the Short Physical Performance Battery (SPPB; 0-12) at 12 months.
We randomized 53/313 eligible participants with a mean (SD) age of 79.7 (7.9) years to intervention (n = 26) and usual care (UC, n = 27), and 49/53 (92%) completed the study. Mean 12-month (SD) SPPB scores in the intervention and UC groups were 9.08 (3.03) and 8.24 (2.44). The between-group difference was 0.9 (95% CI -0.3 to 2.0, p = 0.13). Adverse events were similar in the 2 groups.
The small sample size of less than half our recruitment target precludes definitive conclusions about the effect of our intervention. However, our results are consistent with similar studies on this population and intervention.
髋部骨折住院的老年人综合老年护理（CGC）可以提高活动能力，但尚不清楚在返回社区生活后提供的 CGC 是否比常规出院后护理更能提高活动能力。
确定髋部骨折后第一年门诊为基础的 CGC 方案是否能改善 12 个月时的活动能力表现。
这是一项在加拿大不列颠哥伦比亚省温哥华的 3 家医院进行的、2 臂、1:1 平行组、实用、单盲、单中心、随机对照试验。参与者为社区居住的成年人，年龄≥65 岁，在过去 3-12 个月内发生髋部骨折，无痴呆症，在骨折发生前能行走≥10 米。目标入组人数为 130 人。基于诊所的 CGC 由老年病学家、物理治疗师和职业治疗师提供。主要结局是 12 个月时的简短体能表现测试（SPPB；0-12）。
我们随机将 313 名符合条件的参与者中的 53 人（平均[SD]年龄 79.7[7.9]岁）分为干预组（n=26）和常规护理组（UC，n=27），49/53（92%）人完成了研究。干预组和 UC 组的 12 个月平均（SD）SPPB 评分分别为 9.08（3.03）和 8.24（2.44）。两组之间的差异为 0.9（95%CI-0.3 至 2.0，p=0.13）。两组的不良事件相似。
我们的样本量小于目标招募人数的一半，因此无法确定我们干预措施的效果。然而，我们的结果与该人群和干预措施的类似研究一致。
