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髋部骨折后康复的预后因素与患者骨折前的活动能力和功能状态:一项前瞻性观察研究。

Rehabilitation Prognostic Factors following Hip Fractures Associated with Patient's Pre-Fracture Mobility and Functional Ability: A Prospective Observation Study.

作者信息

Koudouna Smaragda, Evangelopoulos Dimitrios S, Sarantis Michail, Chronopoulos Efstathios, Dontas Ismene A, Pneumaticos Spiridon

机构信息

3rd Department of Orthopaedic Surgery, KAT Hospital, 145 61 Athens, Greece.

Department of Physiotherapy, KAT Hospital, 145 61 Athens, Greece.

出版信息

Life (Basel). 2023 Aug 15;13(8):1748. doi: 10.3390/life13081748.

DOI:10.3390/life13081748
PMID:37629604
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10455283/
Abstract

Low physical function is associated with poor outcomes in the elderly population suffering from hip fractures. The present study aims to evaluate the prognostic tools for predicting patient recovery after hip fractures and investigate the correlation between the pre-fracture motor and functional statuses. A prospective study was performed, including 80 patients suffering from hip fractures. Patient history, previous falls, the type of fracture and overall survival were evaluated. Patient-reported outcome measures (SF-36, EQ-5D/VAS, Charlson Comorbidity Index (CCI), Short Physical Performance Battery (SPPB), Timed Up and Go (TUG) and Harris Hip Score (HHS)) were monitored before hospital discharge at 6 weeks, and 3, 6 and 12 months postoperatively. Overall, 55% of patients experienced at least one fall, and 46% of them used crutches before the fracture. The average CCI score was 6.9. The SPPB score improved from 1.4 ± 1.3 (1 week) to 4.4 ± 2.1 (48 weeks). A one-year age increase, female sex, and prior history of falls lead to 0.1-, 0.92-, 0.56-fold lower SPPB scores, respectively, at 12 months. The HHS recorded the greatest improvement between 6 and 12 weeks (52.1 ± 14.6), whereas the TUG score continued to improve significantly from 139.1 ± 52.6 s (6 weeks) to 66.4 ± 54 s (48 weeks). The SPPB and performance test can be routinely used as a prognostic tool.

摘要

身体功能低下与老年髋部骨折患者的不良预后相关。本研究旨在评估预测髋部骨折患者康复情况的预后工具,并研究骨折前运动和功能状态之间的相关性。进行了一项前瞻性研究,纳入80例髋部骨折患者。评估了患者病史、既往跌倒情况、骨折类型和总体生存率。在出院前、术后6周、3个月、6个月和12个月监测患者报告的结局指标(SF-36、EQ-5D/VAS、Charlson合并症指数(CCI)、简短体能表现量表(SPPB)、计时起立行走测试(TUG)和Harris髋关节评分(HHS))。总体而言,55%的患者至少跌倒过一次,其中46%的患者在骨折前使用过拐杖。平均CCI评分为6.9。SPPB评分从1周时的1.4±1.3提高到48周时的4.4±2.1。在12个月时,年龄每增加一岁、女性以及既往有跌倒史分别导致SPPB评分降低0.1倍、0.92倍和0.56倍。HHS在6至12周之间改善最为明显(52.1±14.6),而TUG评分从6周时的139.1±52.6秒持续显著改善至48周时的66.4±54秒。SPPB和体能测试可常规用作预后工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93c7/10455283/1bb7844c1941/life-13-01748-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93c7/10455283/e55298687990/life-13-01748-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93c7/10455283/1bb7844c1941/life-13-01748-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93c7/10455283/e55298687990/life-13-01748-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93c7/10455283/1bb7844c1941/life-13-01748-g002.jpg

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Exercise to Prevent and Manage Frailty and Fragility Fractures.运动预防和管理虚弱和脆性骨折。
Curr Osteoporos Rep. 2023 Apr;21(2):205-215. doi: 10.1007/s11914-023-00777-8. Epub 2023 Mar 28.
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Recovery and prediction of physical function 1 year following hip fracture.髋部骨折后 1 年的身体功能恢复和预测。
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Analysis of the trajectory and influencing factors of kinesiophobia in elderly patients during the rehabilitation phase of limb fractures.老年肢体骨折患者康复期运动恐惧的轨迹及影响因素分析
Am J Transl Res. 2024 Sep 15;16(9):4819-4829. doi: 10.62347/VXQB6446. eCollection 2024.
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