Department of Traditional Chinese Medicine, General Hospital of Western Theater Command (Chengdu Military General Hospital), Chengdu, China.
Department of General Surgery, General Hospital of Western Theater Command (Chengdu Military General Hospital), Chengdu, China.
Appl Nurs Res. 2021 Dec;62:151491. doi: 10.1016/j.apnr.2021.151491. Epub 2021 Aug 24.
Fragility hip fracture (FHF) is a significant cause of morbidity and mortality in older adults. In 2018, Best Practice Nursing Care Standards for Older Adults with Fragility Hip Fracture (NSOF) were released by The International Collaboration of Orthopaedic Nursing (ICON). However, there are only limited clinical data about the application of this standard in clinical practice in China.
To determine the clinical practice effect of the NSOF.
A retrospective single-centre cohort study was performed from January 2016 to June 2020. Patients were divided into the standardized nursing care group (SN group) and the conventional nursing care group (CN group) depending on whether they were cared for according to the NSOF criteria. The propensity score matched (PSM) analysis was conducted in this study. The perioperative and follow-up outcomes between the two groups were analyzed.
A total of 204 patients diagnosed with FHF were included in the study. After a 1:1 matching, 56 cases were identified in the SN group as well as the CN group. Patients in the SN group had significantly shorter preoperative wait times for surgery (17.4 ± 4.6 vs. 24.4 ± 7.6 h, p < 0.05) and a higher proportion of individuals performing exercise within 24 h after surgery (94.6% vs. 66.1%, p < 0.05). Notably, patients in the SN group also had a significantly shorter length of stay than those in the CN group (9.4 ± 3.1 vs. 14.2 ± 5.1 days, p < 0.05). At the 6-month follow-up, the incidence of refracture was significantly lower (3.6% vs. 14.3%, p < 0.05), and the timed up and go mobility index was improved in the SN group compared to the CN group (20.3 ± 1.7 vs. 24.6 ± 2.2 s, p < 0.05).
This study showed that application of the NSOF resulted in a significant improvement in the treatment of older adults patients with FHF.
脆性髋部骨折（FHF）是老年人发病率和死亡率的重要原因。2018 年，国际骨科护理协作组织（ICON）发布了《老年脆性髋部骨折最佳护理实践标准》（NSOF）。然而，在中国，关于该标准在临床实践中应用的临床数据有限。
确定 NSOF 的临床实践效果。
这是一项回顾性单中心队列研究，于 2016 年 1 月至 2020 年 6 月进行。根据是否按照 NSOF 标准进行护理，将患者分为标准化护理组（SN 组）和常规护理组（CN 组）。本研究采用倾向评分匹配（PSM）分析。分析两组患者的围手术期和随访结果。
共有 204 例脆性髋部骨折患者纳入研究。经过 1：1 匹配，SN 组和 CN 组各有 56 例患者。SN 组患者的术前手术等待时间明显更短（17.4±4.6 比 24.4±7.6 小时，p<0.05），术后 24 小时内进行运动的比例更高（94.6%比 66.1%，p<0.05）。值得注意的是，SN 组患者的住院时间也明显短于 CN 组（9.4±3.1 比 14.2±5.1 天，p<0.05）。6 个月随访时，SN 组的再骨折发生率明显较低（3.6%比 14.3%，p<0.05），且计时起立行走移动指数优于 CN 组（20.3±1.7 比 24.6±2.2 秒，p<0.05）。
本研究表明，应用 NSOF 可显著改善脆性髋部骨折老年患者的治疗效果。
