Yokoyama Kazutaka, Katoh Hiroyuki, Bito Seiji, Fujita Yoshinari, Yamauchi Keita
Graduate School of Health Management, Keio University, Fujisawa 252-0883, Japan.
Department of Orthopedic Surgery, Tokai University School of Medicine, Isehara 259-1193, Japan.
J Clin Med. 2023 Feb 3;12(3):1234. doi: 10.3390/jcm12031234.
In order to explore the factors affecting patients' level of activities of daily living (ADL) on discharge after undergoing bipolar hemiarthroplasty or total hip arthroplasty for displaced femoral neck fractures at an acute care hospital, patient data were analyzed with the following statistical tools: multiple regression analysis (MRA), structural equation modeling (SEM), and simultaneous analysis of several groups (SASG). The Barthel Index (BI) on discharge was set as the objective variable, while age, sex, degree of dementia, BI on admission, number of days from admission to surgery, surgical option, and number of rehabilitation units per day were set as explanatory variables. Factors such as age, sex, degree of dementia, BI on admission, and number of rehabilitation units per day were significant in MRA. While not significant in MRA, the number of days from admission to surgery was significant in SEM. According to the SASG, the number of rehabilitation units per day was significant for patients without dementia but not for patients with dementia. Analysis of real-world data suggests that early surgery and rehabilitation affect ADL on discharge to a greater degree than the surgical method. For patients without dementia, longer daily rehabilitation was significantly associated with better ADL on discharge.
为探究在一家急症医院接受双极半髋关节置换术或全髋关节置换术治疗移位型股骨颈骨折后出院时影响患者日常生活活动（ADL）水平的因素，运用以下统计工具对患者数据进行了分析：多元回归分析（MRA）、结构方程模型（SEM）以及多组同时分析（SASG）。将出院时的巴氏指数（BI）设定为目标变量，同时将年龄、性别、痴呆程度、入院时的BI、入院至手术的天数、手术方式以及每日康复单元数量设定为解释变量。年龄、性别、痴呆程度、入院时的BI以及每日康复单元数量等因素在多元回归分析中具有显著性。入院至手术的天数在多元回归分析中虽不显著，但在结构方程模型中具有显著性。根据多组同时分析结果，每日康复单元数量对无痴呆患者具有显著性，而对痴呆患者则不具有显著性。对真实世界数据的分析表明，早期手术和康复对出院时ADL的影响程度大于手术方式。对于无痴呆患者，每日更长时间的康复与出院时更好的ADL显著相关。
