在脆性髋部骨折患者1年随访中,握力与住院时间和功能结果相关

IF 0.4 Q4 ORTHOPEDICS
I. Au, Nicole Yan Nok Lau, Shirley Ka Wai Lee, Kwok Leung Tiu, Kin Bong Lee, A. Chan
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Methods Patients aged 65 years old or above who were admitted to a local acute hospital from April 2017 to March 2020 due to FHF that were treated operatively, and subsequently attended the multidisciplinary fragility fracture clinic at 1-year follow up were evaluated. HGS measured at pre-operative physiotherapy initial assessment, post-fracture total LOS, Modified Functional Ambulation Classification (MFAC) and Elderly Mobility Scale (EMS) at 1-year follow up were retrieved for analysis. Correlation between HGS and LOS was analyzed using Pearson's correlation coefficient. Correlations between HGS and MFAC, and HGS and EMS were analyzed using Spearman's rank correlation coefficient. Results One hundred and nineteen patients (mean age = 80.8 ± 7.3 years) (33 males, 86 females) were evaluated. Statistical significant negative correlation between HGS and LOS was found (r = -0.245, p = 0.007), implying that the lower the HGS, the longer the period of hospitalization. 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引用次数: 1

摘要

背景/目的脆性髋部骨折(FHF)是最常见的脆性骨折,可导致活动能力恶化和残疾。对于FHF术后有长期住院和功能下降风险的患者,早期发现至关重要,因为这有助于术后管理和医疗资源分配。握力(HGS)是一种易于管理和经济有效的评估全身力量的工具。本研究的目的是研究香港FHF患者术前HGS、住院时间(LOS)和1年随访功能结局之间的关系。方法对2017年4月至2020年3月在当地某急症医院收治的65岁及以上FHF患者进行手术治疗,并于1年随访期间到多学科脆性骨折门诊就诊。取术前物理治疗初始评估HGS、骨折后总LOS、改良功能行走分级(MFAC)和随访1年的老年人活动能力量表(EMS)进行分析。采用Pearson相关系数分析HGS与LOS的相关性。采用Spearman秩相关系数分析HGS与MFAC、HGS与EMS的相关性。结果191例患者(平均年龄80.8±7.3岁),其中男性33例,女性86例。HGS与LOS呈显著负相关(r = -0.245, p = 0.007),说明HGS越低,住院时间越长。HGS与MFAC (r = 0.358, p < 0.001)、EMS (r = 0.507, p < 0.001)也有统计学意义的正相关,说明HGS越大,1年后功能结局越好。简而言之,物理治疗师测量的术前HGS与1年随访时的LOS和功能结果相关。结论HGS与FHF患者的LOS、MFAC和EMS有显著相关性。HGS是一种易于管理和具有成本效益的工具,可帮助一线从业人员确定和分层患者的康复潜力,并随后制定定制的康复和出院计划,如强化培训,护理人员教育和出院目的地的潜在预测。HGS与FHF后患者LOS、MFAC和EMS显著相关。HGS是一种易于管理和具有成本效益的工具,可帮助一线医生确定和分层患者的康复潜力,并随后制定定制的康复和出院计划。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Handgrip strength is associated with length of stay and functional outcomes at 1-year follow up in fragility hip fracture patients
Background/Purpose Fragility hip fracture (FHF) is the most prevalent fragility fracture, causing deterioration in ambulatory ability and disability. Early detection of patients who are at risk of prolonged hospitalization and functional decline after FHF is crucial as this facilitates post-operative management and healthcare resources allocation. Handgrip strength (HGS) is an easily-administered and cost-effective tool to assess whole body strength. The objectives of this study were to examine the relationship between pre-operative HGS, length of stay (LOS) and functional outcomes at 1-year follow up in patients with FHF in Hong Kong. Methods Patients aged 65 years old or above who were admitted to a local acute hospital from April 2017 to March 2020 due to FHF that were treated operatively, and subsequently attended the multidisciplinary fragility fracture clinic at 1-year follow up were evaluated. HGS measured at pre-operative physiotherapy initial assessment, post-fracture total LOS, Modified Functional Ambulation Classification (MFAC) and Elderly Mobility Scale (EMS) at 1-year follow up were retrieved for analysis. Correlation between HGS and LOS was analyzed using Pearson's correlation coefficient. Correlations between HGS and MFAC, and HGS and EMS were analyzed using Spearman's rank correlation coefficient. Results One hundred and nineteen patients (mean age = 80.8 ± 7.3 years) (33 males, 86 females) were evaluated. Statistical significant negative correlation between HGS and LOS was found (r = -0.245, p = 0.007), implying that the lower the HGS, the longer the period of hospitalization. HGS also showed statistical significant positive correlation with MFAC (r = 0.358, p < 0.001) and EMS (r = 0.507, p < 0.001), suggesting that the greater the HGS, the better the functional outcomes after 1 year. In short, pre-operative HGS measured by physiotherapists was shown to be associated with LOS and functional outcomes at 1-year follow up. Conclusion HGS is significantly associated with patient's LOS, MFAC and EMS after FHF. HGS is an easily-administered and cost-effective tool to facilitate frontline practitioners to determine and stratify patients’ rehabilitation potential and subsequently establish customized rehabilitation and discharge plan, such as intensive training, caregiver education and potential prediction of discharge destination. Key Messages HGS is significantly associated with patient's LOS, MFAC and EMS after FHF. HGS is an easily-administered and cost-effective tool to facilitate frontline practitioners to determine and stratify patients’ rehabilitation potential and subsequently establish customized rehabilitation and discharge plan.
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CiteScore
0.60
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