Functional improvement of self-care in the elderly after hip fracture: is age a factor?
Functional improvement of self-care in the elderly after hip fracture: is age a factor?
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DOI：
10.1007/s00402-014-1924-9
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发表时间：
2014-04-01
影响因子：
2.3
通讯作者：
Naidu, Ganesan
中科院分区：
文献类型：
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作者：
Doshi, Hitendra K.;Ramason, Rani;Naidu, Ganesan
亚洲人口老龄化迅速增长，导致手术治疗的髋部骨折数量增加。虽然有证据表明，通过完善的护理模式，患者护理质量和结局得到了改善，但我们不知道这组患者日常生活活动的功能恢复是否也取决于年龄。我们假设老年组（> 85岁）和青年组（< 85岁）的改良Barthel指数（MBI）评分存在差异，将手术治疗的髋部骨折患者（> 60岁）分为A组（<85岁）和B组（> 85岁）。记录人口统计学数据、Charlson合并症指数（CCI）评分、手术时间和住院时间（LOS）。为了评估日常生活活动的恢复，测量了以下时间间隔的MBI评分：跌倒前、出院时、6个月和1年随访时，A组（n = 120）的平均年龄为77岁（60-85），B组（n = 59）的平均年龄为91.8岁（86-108）。平均CCI（A：1.14，B：1.24）、平均手术时间（A：72.3 h，B：79.9 h）和平均LOS（A：10.8天，B：10.3天）无显著差异。损伤前MBI评分（A = 91.5，B = 84.4）存在显著差异（P < 0.05）;然而，出院时（A = 57.5，B = 52.7）、6个月时（A = 74.6，B = 69.3）和1年时（A = 82.2，B = 73.2）测量的评分无显著差异。虽然有一个显着的改善，在1年的分数显着低于伤前scoreforboth groups.We的结论是，年龄不是一个因素，在确定功能恢复方面的日常生活活动的综合模式，照顾老年髋部骨折患者。
The aging population is growing rapidly in Asia resulting in an increased number of hip fractures being managed surgically. Though there is evidence of improved quality of patient care and outcomes with well-established models of care, we do not know if the functional recovery in activities of daily living among this group of patients is also dependant on age. We hypothesize that there will be a difference in Modified Barthel Index (MBI) scores between the 'older old' (> 85 years) and the 'younger old' (< 85 years).Hip fracture patients (> 60 years) treated surgically were divided into Group A (below 85 years) and Group B (above 85 years). Demographic data, Charlson's Comorbidity Index (CCI) score, time to surgery and length of stay (LOS) were recorded. To assess the recovery in activities of daily living, the MBI scores were measured for the following intervals; pre-fall, at discharge, at 6-month and at 1-year follow-up.The mean age for Group A (n = 120) was 77 years (60-85) and the mean age for Group B (n = 59) was 91.8 years (86-108). There was no significant difference in the mean CCI (A: 1.14, B: 1.24), mean time to surgery (A: 72.3 h, B: 79.9 h) and mean LOS (A: 10.8 days, B: 10.3 days). The MBI scores were significantly different (P < 0.05) for the pre-injury scores (A = 91.5, B = 84.4); however, there was no significant difference for scores measured at discharge (A = 57.5, B = 52.7), at 6 months (A = 74.6, B = 69.3) and at 1 year (A = 82.2, B = 73.2). Though there was a significant improvement, the scores at 1 year were significantly lower than the pre-injury score for both groups.We conclude that age is not a factor in determining functional recovery with regard to activities of daily living in an integrated model of care for geriatric hip fracture patients.