Prediction of postoperative morbidity, mortality and rehabilitation in hip fracture patients: the cumulated ambulation score
Prediction of postoperative morbidity, mortality and rehabilitation in hip fracture patients: the cumulated ambulation score
复制标题
髋部骨折患者术后发病率、死亡率和康复的预测：累积步行评分
作者：
N. Foss;M. T. Kristensen;H. Kehlet
目的：验证累积Ambassador评分作为髋部骨折患者术后短期预后的早期预测指标。设计：前瞻性、描述性研究。背景：一所大学医院的髋部骨折骨科。患者：426例连续髋部骨折患者，从自己家中入院，具有独立行走功能。康复遵循明确的多模式康复方案和出院标准。主要结果测量：入院测试采用新的活动度评分评估骨折前的功能活动度和认知功能障碍的简短精神评分。在术后的前三天，使用累积的Ampere评分对患者进行评估，该评分包括对简单Ampere特征的累积评估，评分范围为0 - 18（完全移动的）。这三项评估与短期结局参数相关。结果如下：累积Ambassador评分是住院时间、出院时间、30天死亡率和术后内科并发症的高度显著预测因素（均P < 0.001）。在与所有术后结局参数的相关性方面，累积Ambassador评分上级新活动度评分和精神评分。累积Ambassador评分±10与1个月时99%的存活率和93%的出院回家相关。结论：累积的Ambassador评分是早期预测髋部骨折术后短期结局的潜在有价值的评分。
Objective: To validate the cumulated ambulation score as an early postoperative predictor of short-term outcome in hip fracture patients. Design: Prospective, descriptive study. Setting: An orthopaedic hip fracture unit in a university hospital. Patients: Four hundred and twenty-six consecutive hip fracture patients with an independent walking function admitted from their own home. Rehabilitation followed a well-defined multimodal rehabilitation regimen and discharge criteria. Main outcome measure: Admission tests with a new mobility score to assess prefracture functional mobility and a short mental score for cognitive dysfunction were performed. On the first three postoperative days patients were assessed with the cumulated ambulation score consisting of a cumulated assessment of simple ambulation characteristics with a score from 0 to18 (fully mobile). The three assessments were correlated to short-term outcome parameters. Results: The cumulated ambulation score was a highly significant predictor for length of hospitalization, time to discharge status, 30-day mortality and postoperative medical complications (P < 0.001 for all). The cumulated ambulation score was superior in its association with all postoperative outcome parameters to both the New Mobility Score and the mental score. A cumulated ambulation score of ±10 correlated with a 99% survival at one month and 93% discharge to own home. Conclusion: The cumulated ambulation score is a potentially valuable score for early prediction of short-term postoperative outcome after hip fracture surgery.