Abernathy Bailey R, Schroder Lisa K, Bohn Deborah C, Switzer Julie A
University of Minnesota Medical School, Minneapolis, MN, USA.
Department of Orthopedics, University of Minnesota, Minneapolis, MN, USA.
Geriatr Orthop Surg Rehabil. 2021 Feb 14;12:2151459320985406. doi: 10.1177/2151459320985406. eCollection 2021.
A need exists for improved care pathways for patients experiencing low-energy pelvic ring fractures. A review of the current literature was performed to understand the typical patient care and post-acute rehabilitation pathway within the US healthcare system. We also sought to summarize reported clinical outcomes worldwide. Low-energy pelvic ring fracture patients usually do not qualify for inpatient admission, yet they often require post-acute rehabilitative care. The Center for Medicare and Medicaid Services' (CMS) 3-day rule is a barrier to obtaining financial coverage of this rehabilitative care.
Direct admission of some patients to post-acute care facilities has shown promise with decreased cost, improved patient outcomes, and increased patient satisfaction. Secondary fracture prevention programs may also improve outcomes for this patient population.
Post-acute care innovation and secondary fracture prevention should be prioritized in the low-energy pelvic fragility fracture patient population. To demonstrate the effect and feasibility of these improved care pathways, further studies are necessary.
对于低能量骨盆环骨折患者，需要改进护理路径。对当前文献进行了综述，以了解美国医疗保健系统内典型的患者护理和急性后期康复路径。我们还试图总结全球报道的临床结果。低能量骨盆环骨折患者通常不符合住院条件，但他们往往需要急性后期康复护理。医疗保险和医疗补助服务中心（CMS）的3天规定是获得这种康复护理资金覆盖的障碍。
将一些患者直接送入急性后期护理设施已显示出有望降低成本、改善患者结果并提高患者满意度。二级骨折预防计划也可能改善该患者群体的结果。
对于低能量骨盆脆性骨折患者群体，应优先考虑急性后期护理创新和二级骨折预防。为了证明这些改进护理路径的效果和可行性，还需要进一步研究。
