Weatherall M
Department for the elderly, Waikato Hospital, Hamilton.
N Z Med J. 1993 Oct 27;106(966):451-2.
To analyse the way in which case mix and outcome are related for fracture of the proximal femur in a base hospital.
All patients over age 60 admitted to Waikato Hospital during one year with fracture of the proximal femur were assessed for premorbid function and comorbidity and were followed to discharge.
There was a low frequency of post operative morbid events. Post operative mortality was 3%. Average length of stay was 19.9 days. Increased age and disability, trochanteric fracture, residence in a rest home, previous hypertension or stroke, technical complication, simultaneous fracture of another limb and perioperative myocardial infarction were all associated with increased length of stay.
Factors are described which will alert clinicians to people likely to have a long length of stay and may need formal rehabilitation. Continuous quality improvement techniques may be a way of improving services such as these further.
分析一家基层医院股骨近端骨折的病例组合与治疗结果之间的关系。
对一年内入住怀卡托医院的所有60岁以上股骨近端骨折患者进行病前功能和合并症评估，并随访至出院。
术后发病事件发生率较低。术后死亡率为3%。平均住院时间为19.9天。年龄增加、残疾、转子间骨折、居住在养老院、既往有高血压或中风、技术并发症、另一肢体同时骨折以及围手术期心肌梗死均与住院时间延长有关。
描述了一些因素，这些因素会提醒临床医生注意那些可能住院时间较长且可能需要正规康复治疗的患者。持续质量改进技术可能是进一步改善此类服务的一种方法。
