Orthopaedic Geriatric Care—Is It Effective?
Orthopaedic Geriatric Care—Is It Effective?
复制标题
老年骨科护理——有效吗？
DOI：
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发表时间：
1990
期刊：
影响因子：
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通讯作者：
R. Briggs
中科院分区：
文献类型：
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作者：
V. Hempsall;D. R. Robertson;M. Campbell;R. Briggs
尽管相对较少的正式评估，骨科老年护理已被广泛接受。在东多塞特卫生当局，所有股骨颈骨折患者最初都共用同一矫形设施，但只有来自一个地区的患者随后才能进入老年矫形科，来自其他地区的患者接受标准治疗。我们对155例65岁以上连续发生的股骨颈骨折病例进行了一项基于人群的前瞻性比较。入院时，两国人口在年龄、性别、骨折类型、社会地位、医疗和骨科问题、精神状态和依赖性（老年人克利夫顿评估程序）方面相似。多元回归分析显示，来自可获得骨科老年护理的部门的患者平均住院时间缩短了9.5天（p < 0.05, 95%置信区间为0.6至18.4天）。这种减少不是由于两组之间在依赖性或出院时提供的支持水平方面的任何差异。术后6个月在死亡率、功能结果（疼痛和活动能力）、依赖性改变或社会地位方面没有差异。我们得出的结论是，在东多塞特卫生当局，这种结合的方法导致了住院时间的显著减少，没有任何其他明显的影响，对病人的结果。
Orthopaedic geriatric care has become widely accepted despite relatively little formal evaluation. In the East Dorset health authority all patients with fractured neck of femur initially share common orthopaedic facilities but only those from one geographical sector have subsequent access to an orthopaedic geriatric unit, patients from the other sector receiving standard care. We have carried out a prospective population-based comparison of the outcome of 155 consecutive incident cases of fractured neck of femur aged over 65 years. On admission to hospital the two populations were similar in respect of age, sex, fracture type, social status, medical and orthopaedic problems, mental status and dependency (Clifton assessment procedure for the elderly). Multiple regression analysis showed that the mean length of stay was 9.5 days shorter in patients from the sector with access to orthopaedic geriatric care (p < 0.05, 95% confidence interval 0.6 to 18.4 days). This reduction was not due to any difference between the two groups as regards dependency or the level of support provided on discharge. There was no difference in outcome at 6 months post-operatively in terms of mortality, functional outcome (pain and mobility), change in dependency or social status. We conclude that in the East Dorset health authority this combined approach has resulted in a significant reduction in the length of inpatient stay without any other apparent effect on patient outcome.