Hip Fracture-Related Pain Strongly Influences Functional Performance of Patients With an Intertrochanteric Fracture Upon Discharge From the Hospital
Hip Fracture-Related Pain Strongly Influences Functional Performance of Patients With an Intertrochanteric Fracture Upon Discharge From the Hospital
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DOI：
10.1016/j.pmrj.2012.10.006
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发表时间：
2013-02-01
期刊：
影响因子：
2.1
通讯作者：
Kristensen, Morten Tange
中科院分区：
文献类型：
--
作者：
Kristensen, Morten Tange
目的：检查出院时的功能表现是否受到髋部骨折区域疼痛的影响或与骨折类型相关。设计：前瞻性观察研究。背景：。拥有 20 个床位的髋部骨折骨科病房。 患者： 55 例认知功能完好的患者（20 名男性和 35 名女性；年龄 75.8 +/- 10 岁），其中颈椎髋部骨折 33 例，股骨粗隆间骨折 22 例，术后均允许完全负重。 方法： 所有患者在术后平均 10 6 天出院回家后进行评估。结果测量：由物理治疗师监督的定时起身 (TUG) 测试用于评估功能表现，并使用 5 分言语评分量表（0 = 无痛至 4 = 无法忍受的疼痛）来评估疼痛。 结果：患者平均需要 22.7 +/- 11.7 秒来执行 TUG。颈椎与股骨粗隆间骨折患者的基线特征或止痛药物治疗方面没有观察到显着差异 (P >= .22)，但股骨粗隆间骨折患者在测试期间更常出现中度至重度疼痛 (P < .001)，且 TUG 测试表现较差（29.4 +/- 12.8 秒与 18.3 +/- 8.5 秒）。单变量分析显示，TUG 评分与年龄、通过新活动评分评估的骨折前功能、骨折类型、TUG 表现天数和疼痛强度相关。多元线性回归分析（不包括骨折类型）显示，只有年龄较大（B = 0.34）、骨折前功能较低（B = 7.9）和经历中度至重度疼痛（B = 8.7）与较差的 TUG 评分独立相关。结论：髋部骨折相关疼痛主要影响股骨粗隆间髋部骨折患者出院时的功能表现。物理治疗师应参与新的和优化的骨折型分层疼痛管理策略。总理报告 2013；5:135-141
Objective: To examine whether functional performance upon hospital discharge is influenced by pain in the region of the hip fracture or related to the fracture type.Design: Prospective observational study.Setting:. A 20-bed orthopedic hip fracture unit.Patients: Fifty-five cognitively intact patients (20 men and 35 women; ages 75.8 +/- 10 years), 33 with a cervical hip fracture and 22 with an intertrochanteric hip fracture, all of whom were allowed to bear full weight after surgery.Methods: All patients were evaluated upon discharge from the hospital to their own homes at a mean of 10 6 days after surgery.Main Outcome Measurements: The Timed Up & Go (TUG) test, supervised by a physical therapist, was used to evaluate functional performance, and a 5-point verbal ranking scale (0 = no pain to 4 = intolerable pain) was used to evaluate pain.Results: Patients took an average of 22.7 +/- 11.7 seconds to perform the TUG. No significant differences were observed in baseline characteristics or pain medication given for patients with a cervical versus an intertrochanteric fracture (P >= .22), but patients with an intertrochanteric fracture presented more often with moderate to severe pain during testing (P < .001), with associated poorer performances on the TUG test (29.4 +/- 12.8 seconds versus 18.3 +/- 8.5 seconds). Univariate analysis showed that TUG scores were associated with age, prefracture function evaluated by the New Mobility Score, fracture type, day of TUG performance, and pain intensity. Multivariate linear regression analyses (fracture type not included) showed that only greater age (B = 0.34), low prefracture function (B = 7.9), and experiencing moderate to severe pain (B = 8.7) were independently associated with having a poorer TUG score.Conclusions: Hip fracture related pain primarily compromises the functional performance of patients with an intertrochanteric hip fracture upon discharge from hospital. Physical therapists should be involved in new and optimized fracture-type stratified pain management strategies. PM R 2013;5:135-141