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近亲在老年瑞典髋部骨折患者独立生活和再入院方面的重要性。

The importance of close next of kin for independent living and readmissions among older Swedish hip fracture patients.

机构信息

Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.

出版信息

Health Soc Care Community. 2022 May;30(3):e727-e738. doi: 10.1111/hsc.13443. Epub 2021 May 25.

Abstract

We investigate the importance of adult children and/or cohabitation with a partner for older hip fracture patients' probability of independent living, public home care use and hospital readmission. Data from 35,066 Swedish hip fracture patients between 2012 and 2017, aged 65 years, and living at home at the time of the fracture in the Swedish Registry for Hip Fracture Patients and Treatment were linked with national registers. We applied adjusted logistic regression models and Cox proportional hazard models. In total, 959 (4.0%) women and 817 (7.3%) men had no adult children, 13,384 (56.0%) women and 3,623 (32.5%) men had no cohabiting partner and 2,780 (11.6%) women and 1,389 (12.5%) men neither had a cohabiting partner nor adult children. In comparison with women and men who had both a cohabiting partner and adult children, those without a cohabiting partner (i.e. only adult children) and those who neither had a cohabiting partner nor adult children had significantly lower probabilities of returning home (at discharge and after 4 months). They also had a greater probability of both receiving home care and having an increase in the amount of home care they receive. Having a close next of kin and hospital readmission were not associated. In conclusion, absence of a close next of kin, specifically a cohabiting partner, reduces the chance of return to independent living and increases the use of home care after a hip fracture hospitalisation. The findings highlight the importance of family support for older adults living situation after a hip fracture.

摘要

我们研究了成年子女和/或与伴侣共同居住对老年髋部骨折患者独立生活能力、公共家庭护理使用和医院再入院概率的重要性。数据来自于 2012 年至 2017 年期间瑞典髋部骨折患者登记处和治疗登记处的 35066 名年龄在 65 岁及以上、骨折时居住在家中的瑞典髋部骨折患者,与全国登记处进行了关联。我们应用了调整后的逻辑回归模型和 Cox 比例风险模型。共有 959 名(4.0%)女性和 817 名(7.3%)男性没有成年子女,13384 名(56.0%)女性和 3623 名(32.5%)男性没有同居伴侣,2780 名(11.6%)女性和 1389 名(12.5%)男性既没有同居伴侣也没有成年子女。与既有同居伴侣又有成年子女的女性和男性相比,那些没有同居伴侣(即只有成年子女)和那些既没有同居伴侣也没有成年子女的女性和男性,出院时和 4 个月后返回家庭的概率显著降低。他们也更有可能接受家庭护理,并增加家庭护理的数量。有近亲且再次入院的可能性并不相关。总之,没有近亲,特别是没有同居伴侣,会降低髋部骨折后恢复独立生活的机会,并增加髋部骨折住院后的家庭护理使用。这些发现强调了家庭支持对老年髋部骨折患者生活状况的重要性。

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