Hoenig H, Rubenstein L V, Sloane R, Horner R, Kahn K
Physical Medicine and Rehabilitation Service, Durham Veterans Administration Medical Center, NC, USA.
Arch Intern Med. 1997 Mar 10;157(5):513-20.
To determine the relationship of surgical repair of acute hip fracture within 2 days of hospital admission, followed by more than 5 sessions per week of physical and occupational therapy (PT/OT), to outcomes after acute hip fracture.
Comparison of hip fracture outcomes via secondary analysis of data obtained by retrospective medical record review according to timing of surgical repair and frequency of PT/OT, adjusted for patient, medical care, and hospital characteristics.
The study included the medical records of 1880 elderly Medicare recipients admitted from the community to 284 acute care hospitals in 5 states during 1981 and 1982 or 1985 and 1986 with a primary diagnosis of acute hip fracture who underwent surgical repair and received PT/OT.
None.
The postoperative day when ambulation first occurred, the length of hospital stay, and return to the community.
Earlier surgical repair was associated with a shorter length of hospital stay (5 fewer days, P < .001) without a statistically significant increase in medical complications. High frequency PT/OT was associated with earlier ambulation (odds ratio [OR], 1.76; 95% confidence limits [CL], 1.50, 2.07). Patients who ambulated earlier [corrected] had shorter lengths of stay (6.5 fewer days, P < .001), were more likely to return to the community (OR, 1.45; 95% CL, 1.16, 1.81), and had better 6-month survival (OR, 2.8; 95% CL, 2.06, 3.88), and patients younger than 85 years had fewer in-hospital complications (11% vs 4%, P < .001).
Surgical repair within the first 2 days of hospitalization and more than 5 PT/OT sessions per week were associated with better health outcomes in a nationally representative sample of elderly patients with hip fracture.
确定入院2天内进行急性髋部骨折手术修复，随后每周进行超过5次物理和职业治疗（PT/OT）与急性髋部骨折后结局之间的关系。
通过对根据手术修复时间和PT/OT频率获得的数据进行回顾性病历审查进行二次分析，比较髋部骨折结局，并根据患者、医疗护理和医院特征进行调整。
该研究纳入了1981年和1982年或1985年和1986年期间从社区入住5个州284家急性护理医院的1880名老年医疗保险受益人的病历，这些患者的主要诊断为急性髋部骨折，接受了手术修复并接受了PT/OT。
无。
首次行走的术后天数、住院时间和重返社区情况。
早期手术修复与较短的住院时间相关（少5天，P <.001），且医疗并发症无统计学显著增加。高频PT/OT与更早行走相关（优势比[OR]，1.76；95%置信区间[CL]，1.50，2.07）。更早行走的患者住院时间更短（少6.5天，P <.001），更有可能重返社区（OR，1.45；95%CL，1.16，1.81），6个月生存率更高（OR，2.8；95%CL，2.06，3.88），85岁以下患者院内并发症更少（11%对4%，P <.001）。
在全国具有代表性的老年髋部骨折患者样本中，住院后2天内进行手术修复以及每周进行超过5次PT/OT治疗与更好的健康结局相关。
