120-day follow-up after proximal femoral fractures-first results from the Geriatric Trauma Registry DGU®
120-day follow-up after proximal femoral fractures-first results from the Geriatric Trauma Registry DGU®
复制标题
DOI：
10.1007/s00113-019-00730-4
复制
发表时间：
2020-05-01
期刊：
影响因子：
--
通讯作者：
Buecking, Benjamin
中科院分区：
文献类型：
--
作者：
Schoeneberg, Carsten;Knobe, Matthias;Buecking, Benjamin
根据德国创伤协会（DGU）概述的标准目录，被认证为老年创伤中心DGU（R）状态的老年创伤中心，需要参加老年创伤登记册（ATR-DGU）进行质量管理和结果分析。该评估是假匿名的，包括所有70岁以上接受治疗的髋部骨折患者的数据。自2016年以来一直定期使用。本研究分析了术后120天的步态评估、死亡率、生活质量、再入院率和骨质疏松症治疗情况。方法对2017年开始的ATR-DGU 120天随访进行自愿回顾性数据评价。从已经参与随访的六家诊所获得了分析和发表数据的书面同意。主要目标参数为死亡率、再入院率和翻修率、步态质量、骨质疏松治疗和生活质量（根据EQ-5D-3L）。患者数据完全匿名化，并进行描述性分析。结果共纳入6所医院957例患者。平均年龄为84.5岁（± 6.8岁）。急性治疗期的死亡率为5%。可对412例患者的120天随访进行评价，其中10%的患者因同一骨折并发症需要再次住院，6%的患者需要翻修手术。120天时的死亡率为12%。在54%的患者中，骨折导致活动性恶化，49%的患者在120天后接受骨质疏松治疗。第120天的EQ-5D-3L结果显示，与术后第7天的数值相比有所改善;但是，无法恢复术前的活动能力和生活质量。结论尽管多学科治疗具有明显的优势，但在动员和生活质量方面的结果仍然有限。有必要进一步分析其成因和影响因素。
Background Geriatric trauma centers which are certified to the status of a Geriatic Trauma Center DGU (R) based on the criteria catalogue as outlined by the German Trauma Society (DGU), are required to participate in the Geriatric Trauma Register (ATR-DGU) for quality management and outcome analyses. The evaluation is pseudoanonymous and includes data on all treated hip fracture patients over 70 years old. This has been in regular use since 2016. This study analyzed the postoperative evaluation of gait, mortality, quality of life, hospital readmission and treatment of osteoporosis after 120 days. Methods A voluntary retrospective data evaluation of the ATR-DGU 120-day follow-up from 2017 was carried out. Written consent for the analysis and publication of the data was obtained from six clinics that already participated in the follow-up. The primary target parameters were mortality rate, readmission and revision rates, gait quality, osteoporosis treatment and quality of life according to EQ-5D-3L. The patient data were completely pseudonymized and a descriptive analysis was carried out. Results In this study 957 patients from the 6 hospitals were included. The average age was 84.5 years (+/- 6.8 years). The mortality rate during the acute treatment phase was 5%. The 120-day follow-up could be evaluated in 412 patients, 10% of these required hospital readmission due to complications oft he same fracture and of these 6% required revision surgery. The mortality rate at 120 days was 12%. In 54% of the patients the fracture led to deterioration of mobility and 49% of patients received osteoporosis treatment after 120 days. The results of the EQ-5D-3L at 120 days revealed improvement as compared to the values on postoperative day 7; however, the preoperative status with respect to mobility and quality of life could not be regained. Conclusion Despite the clear advantages of interdisciplinary treatment, the results are still limited concerning mobilization and quality of life. Further analysis of causative and influencing factors is necessary.