Department of Otolaryngology - Head and Neck Surgery, University of Nebraska Medical Center, 981225 Nebraska Medical Center.
College of Medicine, University of Nebraska Medical Center, 985520 Nebraska Medical Center.
Otol Neurotol. 2021 Oct 1;42(9):e1333-e1338. doi: 10.1097/MAO.0000000000003277.
Falls in older adults are associated with high morbidity and mortality. Patients with vestibular disorders may have an increased risk. The purpose of this study was to examine the outcomes among patients with underlying vestibular disorders who have hip fractures and identify predictors of increased morbidity and mortality.
Retrospective cohort study.
Tertiary care academic medical center.
Two hundred one adults diagnosed with a vestibular disorder and hip fracture due to a ground-level fall were compared to 327 age- and sex-matched controls with fractures due to ground-level falls without vestibular diagnoses. Patients were treated between 2013 and 2019.
Length of hospital stay, 30-day readmission rate, and 30-day mortality rate.
Thirty-day readmission rate after hip fracture was significantly increased in patients with vestibular disorders compared to matched controls (p < 0.001), odds ratio 3.12 (95% confidence interval 1.84-5.39). Reasons for readmission in the vestibular patient group included higher rates of repeat falls, infections, and recurrent vestibular symptoms. Use of medication classes associated with falls or hip fractures was not significantly different between groups, except for lower rates of antihypertensive use in the vestibular group (54.0% vs. 67.7%, p = 0.002). No significant difference was found for length of hospital stay (7.34 ± 4.95 vs. 8.14 ± 20.50 days, p = 0.51) or 30-day mortality rate (5.0% vs. 4.6%, p = 0.99). No significant differences were found between groups for age, sex, race, rate of surgical treatment for hip fracture, or disposition at discharge.
Patients with vestibular disorders are at a significantly higher risk of hospital readmission within 30 days after discharge for treatment for hip fracture.
老年人跌倒与高发病率和死亡率相关。患有前庭障碍的患者可能面临更高的风险。本研究旨在检查因地面水平跌倒导致髋部骨折且存在潜在前庭障碍的患者的结局，并确定发病率和死亡率增加的预测因素。
回顾性队列研究。
三级保健学术医疗中心。
2013 年至 2019 年期间，201 名被诊断为前庭障碍和因地面水平跌倒导致髋部骨折的成年人与 327 名年龄和性别匹配的因地面水平跌倒且无前庭诊断导致骨折的对照组进行比较。
住院时间、30 天再入院率和 30 天死亡率。
与对照组相比，患有前庭障碍的髋部骨折患者 30 天再入院率显著增加（p<0.001），优势比为 3.12（95%置信区间 1.84-5.39）。前庭障碍患者组再入院的原因包括更高的跌倒、感染和复发性前庭症状发生率。除了前庭障碍组的降压药使用率较低（54.0% vs. 67.7%，p=0.002）外，两组之间与跌倒或髋部骨折相关的药物使用类别没有显著差异。两组的住院时间（7.34±4.95 天 vs. 8.14±20.50 天，p=0.51）或 30 天死亡率（5.0% vs. 4.6%，p=0.99）均无显著差异。两组在年龄、性别、种族、髋部骨折手术治疗率或出院时的处置方式方面均无显著差异。
患有前庭障碍的患者在因髋部骨折接受治疗出院后 30 天内再次入院的风险显著增加。
