Kiel D P, Eichorn A, Intrator O, Silliman R A, Mor V
Hebrew Rehabilitation Center for Aged Research and Training Institute, Boston, MA 02131.
Am J Public Health. 1994 Aug;84(8):1281-6. doi: 10.2105/ajph.84.8.1281.
The outcomes of elderly, hospitalized patients discharged to nursing homes after hip fracture were examined.
For 2624 hip fracture patients admitted to any of 43 proprietary nursing homes between 1984 and 1988, admission assessments were examined in relation to 1-month outcomes.
Mean patient age was 82 +/- 7 y; 85% of the sample were female. Within 1 month after discharge, 24% had returned home, 12% had been rehospitalized, 3% had died, and 61% remained in the nursing home. Characteristics significantly associated with morality included disorientation, functional dependency, neurologic diagnoses, and use of cardiac medications, antidepressants, or narcotics. Rehospitalization was significantly associated with age, gender, living with someone, being ambulatory, and functional dependency. Returning home was associated with younger age, living with someone, being ambulatory, and having no disorientation, functional dependency, or psychiatric or neurologic diagnoses, nor any pressure sores.
Better-functioning persons and those with social support returned home; physically and cognitively impaired persons and those taking narcotics, cardiac medications, or antidepressants were likely to die; and younger men, those with social support, those with functional dependency, and those who were free of disorientation were more likely to be rehospitalized.
研究老年髋部骨折患者出院后入住疗养院的结局。
对1984年至1988年间入住43家私立疗养院的2624例髋部骨折患者,检查其入院评估与1个月结局的关系。
患者平均年龄为82±7岁;样本中85%为女性。出院后1个月内,24%已回家,12%再次住院,3%死亡,61%仍留在疗养院。与死亡率显著相关的特征包括定向障碍、功能依赖、神经学诊断以及使用心脏药物、抗抑郁药或麻醉药。再次住院与年龄、性别、与他人同住、能行走以及功能依赖显著相关。回家与年龄较小、与他人同住、能行走且无定向障碍、功能依赖、精神或神经学诊断以及无压疮有关。
功能较好且有社会支持的人回家;身体和认知受损以及服用麻醉药、心脏药物或抗抑郁药的人可能死亡;年轻男性、有社会支持的人、有功能依赖的人以及无定向障碍的人更有可能再次住院。