Takahashi Ai, Naruse Hiroaki, Hasegawa Daiki, Nakajima Hideaki, Matsumine Akihiko
Department of Orthopaedics and Rehabilitation Medicine, University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan.
Division of Rehabilitation Medicine, University of Fukui Hospital, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan.
J Clin Med. 2025 May 14;14(10):3430. doi: 10.3390/jcm14103430.
Osteoporotic hip fractures in the elderly significantly impact mobility and quality of life. Optimising early management is crucial for improving the functional outcomes. This single-centre retrospective cohort study included patients with femoral trochanteric (n = 142) or femoral neck fractures (n = 127) treated between January 2016 and March 2023. The patients were divided into ambulatory and non-ambulatory groups based on their walking ability at discharge from the rehabilitation hospital. The explanatory variables included age, sex, fracture type, surgical method, pre-surgical days, hospital days, dementia, and the Nursing Needs Score (NNS). The most common age group was 85-89 years old. Only 23.4% of patients underwent surgery within 2 days of admission. The median hospital stay was 20 days in acute care and 52 days in rehabilitation hospitals. Walking ability declined in 66.9% of the patients. Pre-injury mobility and acute care hospital NNS were identified as independent predictors of ambulatory outcomes. Pre-injury mobility and the Nursing Needs Score (NNS) assessed at the acute care hospital were identified as critical determinants of postoperative ambulatory status. These findings highlight the importance of community collaboration and preventive rehabilitation strategies aimed at improving basic mobility, maintaining cognitive function, and preserving walking ability.
老年人骨质疏松性髋部骨折会显著影响活动能力和生活质量。优化早期管理对于改善功能结局至关重要。这项单中心回顾性队列研究纳入了2016年1月至2023年3月期间接受治疗的股骨转子间骨折患者（n = 142）或股骨颈骨折患者（n = 127）。根据康复医院出院时的行走能力，将患者分为可步行组和不可步行组。解释变量包括年龄、性别、骨折类型、手术方法、术前天数、住院天数、痴呆症和护理需求评分（NNS）。最常见的年龄组为85 - 89岁。只有23.4%的患者在入院后2天内接受了手术。急性护理的中位住院时间为20天，康复医院为52天。66.9%的患者行走能力下降。伤前活动能力和急性护理医院的NNS被确定为可步行结局的独立预测因素。伤前活动能力和在急性护理医院评估的护理需求评分（NNS）被确定为术后行走状态的关键决定因素。这些发现凸显了社区合作以及旨在改善基本活动能力､维持认知功能和保持行走能力的预防性康复策略的重要性。
