Diabetes and Health Outcomes Among Older Taiwanese with Hip Fracture
Diabetes and Health Outcomes Among Older Taiwanese with Hip Fracture
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DOI：
10.1089/rej.2011.1308
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发表时间：
2012-10-01
影响因子：
2.6
通讯作者：
Wu, Chi-Chuan
中科院分区：
文献类型：
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作者：
Huang, Yueh-Fang;Shyu, Yea-Ing L.;Wu, Chi-Chuan
目的：髋部骨折严重影响老年人的功能，发病率高，死亡率高，严重影响患者的康复。糖尿病是老年人群中常见的并存疾病，但对糖尿病对亚洲老年髋部骨折患者预后的影响知之甚少。研究设计和方法：本研究对242名社区老年髋部骨折患者的数据进行二次分析，这些数据来自前三项纵向研究。61例(25.2%)合并糖尿病。结果：髋部骨折合并糖尿病老年患者出院后第一年的死亡率(22.6%比10.3%，p=0.03)和再住院率(10.0%比2.5%，P=0.03)显著高于对照组，差异有统计学意义(P<0.05)。P=0.04)出院后1~3个月较无糖尿病组明显减少。在控制协变量后，没有糖尿病的老年参与者在出院后第一年内步行能力恢复的几率是糖尿病患者的2.2倍(可信区间=1.15-4.21)，总体健康(Beta=9.33；p=0.01)和身体功能(Beta=7.26；p=0.02)更好。结论：糖尿病对老年髋部骨折患者的预后产生负面影响。本研究结果可为老年糖尿病髋部骨折患者制定干预措施提供参考。
Objective: Hip fracture tremendously impacts functional abilities for the elderly with high morbidity and mortality; recovery is compromised by co-morbidities. Diabetes mellitus is a common co-morbidity for the aging population, but little is known about the influence of diabetes on outcomes of the Asian elderly with hip fracture.Research Design and Methods: This study was a secondary analysis of data on 242 community-dwelling elders with hip fracture from three previous longitudinal studies. Sixty-one cases (25.2%) had diabetes. Outcomes were measured by the Chinese Barthel Index, Medical Outcomes Study Short Form-36 Taiwan version, and analyzed by the generalized estimating equation approach to examine how diabetes influenced hip-fractured elders' mortality, service utilization, mobility, daily activities, and health-related quality of life during the first 12 months after postsurgical discharge in Taiwan.Results: Hip-fractured elderly with diabetes had a significantly higher mortality rate (22.6% vs. 10.3%, p = 0.03) during the first year following discharge, and significantly higher readmission rate (10.0% vs. 2.5%, p = 0.04) from the first to third month following discharge than those without diabetes. After controlling for covariates, elderly participants without diabetes had an overall 2.2 times (confidence interval [ CI] = 1.15-4.21) greater odds of recovery in walking ability and better reported general health (beta = 9.33; p = 0.01) and physical functioning (beta = 7.26; p = 0.02) than those with diabetes during the first year after discharge.Conclusions: Diabetes negatively influenced outcomes of elderly patients with hip fracture. The results may provide a reference for developing interventions for hip-fractured elders with diabetes.