| Autor: |
Cecchi, Francesca, Pancani, Silvia, Antonioli, Desiderio, Avila, Lucia, Barilli, Manuele, Gambini, Massimo, Landucci Pellegrini, Lucilla, Romano, Emanuela, Sarti, Chiara, Zingoni, Margherita, Gabrielli, Maria Assunta, Vannetti, Federica, Pasquini, Guido, Macchi, Claudio |
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| Zdroj: |
BMC Geriatrics; 8/31/2018, Vol. 18 Issue 1, p1-8, 8p, 5 Charts |
| Abstrakt: |
Background: Despite progress in surgery and care, hip fracture (HF) remains a catastrophic event, burdened with high risk of mortality and disability. This study aims at identifying predictors of recovering ambulation after intensive inpatient rehabilitation within the Tuscany Region HF rehabilitation pathway.Methods: All HF patients referred from acute care to the two Massa-Carrara Rehabilitation facilities January 2015-June 2017 were enrolled. Comorbidity Total Score (CIRS) defined high- or low-care setting referral. Recovery of ambulation, with or without aid, (assessed by SAHFE) was the primary outcome. Personal data, comorbidity, cognitive (MMSe) and pre-fracture function (mRANKIN) were recorded on admission. Outcomes included hospital readmission, length of stay (LOS) and home discharge. Urinary catheter, bedsores, disability (modified Barthel Index-mBI), communication disability (CDS), trunk control (TCT), pain (NRS), and ambulation were recorded (admission-discharge).Results: Of 352 patients enrolled (age 83.9 ± 7.1; 80% women), 1 died and 6 were readmitted to acute-care hospital; 97% patients referred to high-care, and 64% referred to low-care, presented moderate-high comorbidity on admission. Median LOS was 22 days; 95% patients were discharged back home; daily functional gain (mBIscore/LOS) was 1.3 ± 0.7. Patients who recovered ambulation on discharge were 84%. Older age, higher comorbidity, bladder catheter, impaired trunk control, worse cognitive and functional status on admission, and pre-fracture disability were associated to poor outcome, but only higher comorbidity and impaired communication on admission predicted failure to recover ambulation on discharge.Conclusion: In HF patients entitled to intensive inpatient rehabilitation, moderate-high comorbidity and impaired communication are frequent findings and predict rehabilitation failure. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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