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老年创伤患者的急性老年病治疗:对活动能力、自主性及出院后去向的影响

[Acute geriatric treatment of older trauma patients : Influence on mobility, autonomy and postdischarge destination].

作者信息

Palzer M, Meyer U, Abderhalden L A, Gazzotti A, Hierholzer C, Bischoff-Ferrari H A, Freystätter G

机构信息

Zentrum Alter und Mobilität, Universität Zürich, Zürich, Schweiz.

Klinik für Geriatrie, Universitätsspital Zürich, Rämistrasse 101, 8091, Zürich, Schweiz.

出版信息

Z Gerontol Geriatr. 2021 Dec;54(8):816-822. doi: 10.1007/s00391-020-01812-4. Epub 2020 Nov 17.

Abstract

BACKGROUND

Acute geriatric treatment is a type of early rehabilitation for hospitalized seniors to maintain personal autonomy and to avoid nursing home placement.

OBJECTIVE

The aim of the study was to describe the changes of mobility and functional independence of older trauma patients during acute geriatric treatment.

MATERIAL AND METHODS

This study analyzed admission and discharge assessment data from 164 patients in the geriatric department with fall-related injuries. Mobility and performance in activities of daily living were assessed using the short physical performance battery (SPPB), gait speed and Barthel index. We analyzed changes in mobility from admission to discharge (t-test) and examined differences in mobility between patients returning home and those admitted to long-term care (age-adjusted and gender-adjusted linear regression model).

RESULTS

Patients improved their mobility measured by the SPPB by 1.8 points ± 2.1 points, gait speed by 0.10 ± 0.14 m/s and the Barthel index by 13 ± 16 points, all p < 0.001). The number of patients not able to walk decreased from 43% to 14% (p = 0.003). Of the community-dwelling patients 73% were discharged either directly back home or after rehabilitation outside the hospital as a transitional solution.

CONCLUSION

In the context of acute geriatric treatment older trauma patients significantly improved their mobility and performance. The majority of patients could return home.

摘要

背景

急性老年病治疗是一种针对住院老年人的早期康复治疗,旨在维持其个人自主能力并避免入住养老院。

目的

本研究旨在描述老年创伤患者在急性老年病治疗期间的活动能力和功能独立性的变化。

材料与方法

本研究分析了老年科164例因跌倒受伤患者的入院和出院评估数据。使用简短体能状况量表(SPPB)、步速和巴氏指数评估活动能力和日常生活表现。我们分析了从入院到出院的活动能力变化(t检验),并检查了回家患者和入住长期护理机构患者之间的活动能力差异(年龄和性别调整的线性回归模型)。

结果

患者的SPPB评分提高了1.8分±2.1分,步速提高了0.10±0.14米/秒,巴氏指数提高了13±16分,所有p<0.001)。无法行走的患者数量从43%降至14%(p=0.003)。在社区居住患者中,73%的患者直接出院回家或在院外康复后作为过渡方案回家。

结论

在急性老年病治疗的背景下,老年创伤患者的活动能力和表现显著改善。大多数患者能够回家。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b62/8636419/9f3f150900ca/391_2020_1812_Fig1_HTML.jpg

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