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題 名 | Predictors of Postoperative Functional Recovery upon Discharge in Elderly Patients Hospitalized with a Hip Fracture--A Pilot Study=高齡髖關節骨折住院病患手術後活動功能恢復預測因子--前驅研究 |
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作 者 | 林時逸; 陳志輝; 周吟怡; 翁碩駿; 林鉅勝; 李毓珊; 朱莉螢; | 書刊名 | 臺灣老年醫學暨老年學雜誌 |
卷 期 | 12:1 2017.02[民106.02] |
頁 次 | 頁42-54 |
分類號 | 419.76 |
關鍵詞 | 老年評估; 高齡病患; 髖關節骨折; 活動功能; Activity of daily living; Elderly; Comprehensive geriatric assessment; Hip fracture; |
語 文 | 英文(English) |
中文摘要 | 目的:高齡髖關節骨折病患出院時之活動功能,對於後續復健治療計畫與服務準備是項很重要的指標。本研究目的乃利用老年周全評估方法,探討高齡髖關節骨折病患,手術後功能恢復之相關預測因子。方法:我們於2016年期間總共連續納入50位高齡髖關節骨折住院病患,所有患者皆接受老年周全評估,以探討出院前活動功能恢復預測因子。結果:平均年紀為80.2±7.9歲,56%為女性。在髖關節骨折發生前,49位曾有跌倒史,24位行走時需輔具幫忙。Charlson共病指數平均值2.1±1.2,平均日常生活功能指數為75.5±24.8分。剛於住院手術後,所有患者平均日常生活功能指數降至22.5±16.8分,但於出院時則略增為36.3±20.7分,平均住院日數為11.1±9.7天。經由單變異迴歸分析顯示出院前日常生活功能指數與年齡、骨折前日常生活功能、共病指數、認知功能與營養評估指數呈現相關。進一步進行多變異分析顯示,經其他因子校正後,骨折前日常生活功能與出院時日常生功能指標兩者明顯呈現統計正相關。結論:本研究結果顯示透過老年周全評估,能幫助找出高齡髖關節骨折手術後病患,短期日常生活功能進步之相關因子,進而能協助做好住院期間復健治療處置。 |
英文摘要 | Objectives: The level of functional mobility upon hospital discharge is an important indicator for elderly patients who had been hospitalized with a hip fracture as it provides planning for the care needs, and rehabilitative strategies for these patients. The aim of this study was to determine the predictors of postoperative functional recovery in elderly patients hospitalized with a hip fracture. Methods: A total of 50 elderly patients with hip fractures were admitted to a medical center in Central Taiwan, and were enrolled in the study. A comprehensive geriatric assessment was used to examine factors associated with the regaining of mobility upon discharge after hip fracture surgery. Results: Prior to their hip fractures, among the 50 elderly patients (mean age 80.2±7.9 years; 56% women), 24 had abnormal mobility category with forty-nine of the patients having at least one fall episode. The mean Charlson Comorbidity Index (CCI) score was 2.1±1.2. Before hip fracture, the mean Activity of Daily Living (ADL) point was 75.5±24.8, decreased significantly to 22.5±16.8 points upon admission, and improved to 36.3±20.7 points after hip surgery at discharge, where the mean hospital length of stay was 11.1±9.7 days. Univariate analysis revealed that pre-discharge ADL was associated with age, prefracture ADL, CCI, Mini-Mental State Examination (MMSE), and Minimal Nutrition Assessment (MNA) scores. Using the multivariate linear regression analysis, it was shown that before injury ADL score was still correlated with the pre-discharge ADL after adjustment of the other factors. Conclusion: It was concluded that a comprehensive geriatric assessment can assist in identifying older patients with a hip fracture who are at risk of experiencing a lower postoperative functional recovery during hospitalization, allowing for proper strategies to be arranged in order to acquire the necessary functional improvement prior to discharge. |
本系統中英文摘要資訊取自各篇刊載內容。