Koval K J, Skovron M L, Aharonoff G B, Meadows S E, Zuckerman J D
Department of Orthopaedic Surgery, Hospital for Joint Diseases, New York, NY 10003, USA.
Clin Orthop Relat Res. 1995 Jan(310):150-9.
Three hundred thirty-six community-dwelling, previously ambulatory, geriatric patients with hip fracture were observed prospectively to determine ambulatory ability at a minimum followup of 1 year. One hundred thirty-seven (41%) patients maintained their prefracture ambulatory ability at a minimum followup of 1 year; 134 (40%) patients remained ambulatory but became more dependent on assistive devices; 39 (12%) previous community ambulators became household ambulators, and 26 (8%) patients became nonfunctional ambulators. Analysis was performed to determine which pre- and postinjury factors were predictive of failure to recover ambulatory capacity 1 year after fracture. Potential predictor variables analyzed included age, gender, number of comorbid conditions, prefracture ambulatory ability, prefracture living situation, fracture type, American Society of Anesthesiologists rating of operative risk, type of surgery, and number of postoperative complications. Multiple logistic regression analysis identified significant contributions of age, prefracture ambulatory ability, American Society of Anesthesiologists rating of operative risk, and fracture type to ambulatory recovery.
对336例社区居住、既往可独立行走的老年髋部骨折患者进行前瞻性观察，以确定在至少1年的随访期内的行走能力。137例（41%）患者在至少1年的随访期内保持了骨折前的行走能力；134例（40%）患者仍可行走，但对辅助器械的依赖增加；39例（12%）既往可在社区行走的患者变为只能在室内行走，26例（8%）患者变为无功能行走者。进行分析以确定哪些伤前和伤后因素可预测骨折后1年行走能力未能恢复。分析的潜在预测变量包括年龄、性别、合并症数量、骨折前行走能力、骨折前生活状况、骨折类型、美国麻醉医师协会手术风险分级、手术类型和术后并发症数量。多因素logistic回归分析确定年龄、骨折前行走能力、美国麻醉医师协会手术风险分级和骨折类型对行走恢复有显著影响。
