School of Health Sciences, Japan University of Health Sciences, Hirasuka, Satte City, Saitama, Japan.
Department of Rehabilitation, Gunma Paz University, Takasaki City, Gunma, Japan.
Physiother Res Int. 2024 Jan;29(1):e2049. doi: 10.1002/pri.2049. Epub 2023 Sep 30.
This retrospective cohort study aimed to investigate the effect of rehabilitation and without weekend therapy on Activities of daily living (ADL) and readmission in vertebral fracture patients aged 60 years and older.
The present study used a hospital-based database created by JMDC Inc. The JMDC hospital-based database is an epidemiological database that has been storing medical claims and Diagnosis Procedure Combination survey data. This study included 40,743 admitted patients aged 60 years or older who were admitted for rehabilitation purposes with a diagnosis of compression fracture of the thoracic and/or lumbar spine based on a previous diagnostic survey. We extracted the medical information from the database. Patients who received rehabilitation 7 days a week were classified into two groups: the "weekend rehabilitation group" and "nonweekend rehabilitation group." To reduce confounding effects related to differences in patient background, we used propensity score with multiple logistic regression models. Analysis of the JMDC database was conducted with the approval of the Institutional Review Board (approval number: 1228-1). Because all data were anonymized, informed consent was not required.
Propensity score matching resulted in 13,790 cases being included in the analysis. Barthel index (BI) at discharge, change in BI, and readmission were significantly different between the weekend rehabilitation and nonweekend rehabilitation groups. Multiple logistic regression analysis suggested a reduced odds of readmission with weekend rehabilitation (odds ratio = 0.907, 95% confidence interval [CI] = 0.843-0.975, p-value = 0.008). Furthermore, greater changes in BI and BI at discharge were associated with the effect of weekend rehabilitation (unstandardized [B] = 3.922, 95% CI = 2.925-4.919), (unstandardized [B] = 3.512, 9% CI = 2.424-4.6), respectively.
Weekend rehabilitation was considered as an important part of the treatment program to acquire ADL and to prevent readmission.
本回顾性队列研究旨在探讨康复治疗和非周末治疗对 60 岁及以上椎体骨折患者日常生活活动（ADL）和再入院的影响。
本研究使用了 JMDC 公司创建的医院数据库。JMDC 医院数据库是一个存储医疗索赔和诊断程序组合调查数据的流行病学数据库。本研究纳入了 40743 名因胸腰椎压缩性骨折而接受康复治疗的 60 岁及以上住院患者，这些患者的诊断均基于之前的诊断调查。我们从数据库中提取了患者的医疗信息。将每周接受 7 天康复治疗的患者分为两组：“周末康复组”和“非周末康复组”。为了减少与患者背景差异相关的混杂效应，我们使用了多变量逻辑回归模型进行倾向评分匹配。JMDC 数据库的分析得到了机构审查委员会的批准（批准号：1228-1）。由于所有数据均经过匿名化处理，因此无需获得患者的知情同意。
倾向评分匹配后，共纳入 13790 例患者进行分析。出院时的巴氏指数（BI）、BI 的变化以及再入院率在周末康复组和非周末康复组之间存在显著差异。多变量逻辑回归分析表明，周末康复治疗可降低再入院的可能性（比值比=0.907，95%置信区间[CI]：0.843-0.975，p 值=0.008）。此外，BI 的变化和出院时的 BI 与周末康复治疗的效果相关（未标准化[B]=3.922，95%CI：2.925-4.919），（未标准化[B]=3.512，9%CI：2.424-4.6）。
周末康复治疗被认为是获得 ADL 和预防再入院的重要治疗方案的一部分。
