da Casa Carmen, Pablos-Hernández Carmen, González-Ramírez Alfonso, Blanco Juan F
Instituto de investigación biomédica de Salamanca (IBSAL), Salamanca, Spain.
Othogeriatric Unit, Hospital Universitario de Salamanca, Salamanca, Spain.
Clin Interv Aging. 2021 Apr 28;16:721-729. doi: 10.2147/CIA.S302620. eCollection 2021.
The 30-day mortality rate after hip fracture surgery has been considered as an indirect indicator of the quality of care. This work aims to appraise the Barthel Index, Katz Index, Lawton-Brody Index, and Physical Red Cross Scale registered in the Comprehensive Geriatric Assessment at admission on the of 30-day death probability after hip fracture surgery.
Prospective study including 899 hip fracture patients over 65. Bed-ridden, non-surgically treated patients, and high energy trauma or tumoral etiology fractures were excluded. Variables distribution were assessed by χ, U-Mann Whitney and we performed binary logistic regression and equal tailed Jeffreys 95% CI for risk assessment. P<0.05 was considered statistically significant.
We noted a 30-day mortality rate of 5.9%. We related Barthel Index (OR=0.986 [0.975-0.996], p=0.010), Katz Index (OR=1.254 [1.089-1.444], p=0.002), Lawton-Brody Index (OR=0.885 [0.788-0.992], p=0.037), and Physical Red Cross Scale (OR=1.483 [1.094-2.011], p=0.011) with the 30-day mortality of patients after hip fracture surgery. We also validated the Barthel Index inflection point (0-55) (OR=2.428 [1.379-4.275], p=0.002) and Katz Index inflection point (A-B) (OR=0.493 [0.273-0.891], p=0.019) for the assessment of the highest risked patients.
The geriatric functional status scores would be useful multifunctional and standalone tools in the assessment of hip fracture patients as singly predictors of 30-day mortality.
髋部骨折手术后30天死亡率一直被视为护理质量的间接指标。本研究旨在评估入院时综合老年评估中记录的Barthel指数、Katz指数、Lawton-Brody指数和红十字体能量表对髋部骨折手术后30天死亡概率的影响。
对899名65岁以上的髋部骨折患者进行前瞻性研究。排除卧床、非手术治疗的患者以及高能创伤或肿瘤病因导致的骨折患者。通过χ检验、U-Mann Whitney检验评估变量分布，并进行二元逻辑回归和等尾Jeffreys 95%置信区间进行风险评估。P<0.05被认为具有统计学意义。
我们发现30天死亡率为5.9%。我们将Barthel指数（OR=0.986 [0.975-0.996]，p=0.010）、Katz指数（OR=1.254 [1.089-1.444]，p=0.002）、Lawton-Brody指数（OR=0.885 [0.788-0.992]，p=0.037）和红十字体能量表（OR=1.483 [1.094-2.011]，p=0.011）与髋部骨折手术后患者的30天死亡率相关联。我们还验证了Barthel指数拐点（0-55）（OR=2.428 [1.379-4.275]，p=0.002）和Katz指数拐点（A-B）（OR=0.493 [0.273-0.891]，p=0.019）用于评估高危患者。
老年功能状态评分将是评估髋部骨折患者30天死亡率单一预测指标的有用的多功能独立工具。
