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老年患者髋部骨折手术后早期坐立与功能活动恢复之间的关联:一项前瞻性队列研究。

Association between early sitting and functional mobility recovery after hip-fracture surgery in older patients: a prospective cohort study.

作者信息

Catalano-Nadakhovskaia Clarissa, Pérez-López Carlos, García-Lerma Esther, Ivanov Laura Alexandra, Macho-Perez Oscar, Rodríguez-Molinero Alejandro

机构信息

Geriatric Unit, Consorci Sanitari Alt Penedès i Garraf, Sant Pere de Ribes, Barcelona, Spain.

Research Area, Consorci Sanitari Alt Penedès i Garraf, Sant Pere de Ribes, Barcelona, Spain.

出版信息

BMC Geriatr. 2025 Mar 18;25(1):184. doi: 10.1186/s12877-025-05831-x.

Abstract

BACKGROUND

Hip fractures significantly impact older adults, leading to compromised mobility and various adverse outcomes. The importance of early post-surgery mobilization in regaining pre-fracture levels of mobility is recognized, but lacks standardized definitions and implementation strategies. This study aimed to assess the impact of early sitting position 24 h after hip-fracture surgery on functional mobility recovery after 30 days using data from the Spanish National Hip Fracture Registry (RNFC).

METHODS

Prospective cohort study, including patients aged ≥ 75 years admitted for hip-fracture surgery between 2017 and 2020 at Sant Camil Residential Hospital. Data from the RNFC were analyzed, and linear regression models were developed to assess the association between early sitting after surgery (ESAS) and mobility recovery at 30 days after surgery.

RESULTS

Of 486 identified patients, 321 were included, with an estimated ESAS prevalence of 38.32% (95% CI: 32.97-43.88). ESAS was significantly associated with improved mobility recovery at 30 days. Multivariate regression models consistently revealed ESAS as a modest independent predictor of better post-surgery mobility. Factors such as age, cognitive capacity, and general health also impacted mobility recovery.

CONCLUSION

The ESAS effect, while modest, emerges as a significant predictor of hip mobility recovery among older patients with hip fractures 30 days after surgery. These findings underscore the potential of this low-risk, low-cost intervention in enhancing functional mobility recovery strategies and emphasize the need for further research to uncover its broader implications in post-operative care. Implementation of early sitting could be enhanced, as only a third of patients in our study underwent this simple intervention.

摘要

背景

髋部骨折对老年人有显著影响,导致行动能力受损及各种不良后果。术后早期活动对于恢复骨折前的行动水平的重要性已得到认可,但缺乏标准化定义和实施策略。本研究旨在利用西班牙国家髋部骨折登记处(RNFC)的数据,评估髋部骨折手术后24小时早期坐位对30天后功能活动恢复的影响。

方法

前瞻性队列研究,纳入2017年至2020年期间在圣卡米尔疗养院医院因髋部骨折手术入院的年龄≥75岁的患者。分析RNFC的数据,并建立线性回归模型以评估术后早期坐位(ESAS)与术后30天活动恢复之间的关联。

结果

在486名确诊患者中,321名被纳入研究,估计ESAS患病率为38.32%(95%CI:32.97 - 43.88)。ESAS与30天时活动恢复的改善显著相关。多变量回归模型一致显示ESAS是术后活动改善的一个适度独立预测因素。年龄、认知能力和总体健康等因素也影响活动恢复。

结论

ESAS的影响虽适度,但在髋部骨折老年患者术后30天成为髋部活动恢复的一个重要预测因素。这些发现强调了这种低风险、低成本干预在增强功能活动恢复策略方面的潜力,并强调需要进一步研究以揭示其在术后护理中的更广泛意义。早期坐位的实施可以加强,因为在我们的研究中只有三分之一的患者接受了这种简单的干预。

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