股関節骨折の患者を対象とした総合的な高齢者介護:前向き,ランダム化,制御試験
Anders Prestmo1, Gunhild Hagen2, Olav Sletvold1
1Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway; Department of Geriatrics, St Olav Hospital, University Hospital of Trondheim, Trondheim, Norway.
Lancet (London, England)
|February 10, 2015
まとめ
70歳以上の股関節骨折患者に対する総合的な高齢医療では,標準的な整形外科医療と比較して4ヶ月で運動能力が向上しました. これは,オートゴリアトリックケアが,股関節骨折の高齢者に有益であることを示唆しています.
科学分野:
- ゲリアトリック・メディシン (老年医学)
- 整形外科 整形外科
- 医療サービス 研究 医療サービス
背景:
- 股関節骨折は,高齢者 (>70歳以上) に不釣り合いな影響を及ぼし,脆弱性,機能低下,不良の結果,および医療費の増加につながります.
- 伝統的な整形外科医療は,高齢の股関節骨折患者の複雑なニーズに適切に対処できない可能性があります.
研究 の 目的:
- 70歳以上で股関節骨折を患っている患者の総合的な高齢医療の効果と費用対効果を標準的な整形外科医療と比較する.
- 患者移動に対する統合的正統老年介護の影響を評価する.
主な方法:
- 397人の患者を対象とした前向きな,単一センター,ランダム化制御試験である (198 件の総合的な高齢者ケア, 199 件の整形外科ケア).
- 骨折前に10m歩けていた70歳以上の患者をランダムに割り当てました.
- 主なアウトカム:手術後4ヶ月で短時間身体能力バッテリー (SPPB) で測定された移動能力.
主要な成果:
- 4ヶ月の平均SPPBスコアは,整体老年医療グループ (5.12) で,整形外科医療グループ (4.38) と比較して,有意に高かった.
- SPPBスコアのグループ間差は0.74 (95%CI 0.18-1.30,p=0.010) でした.
- 脱退率は類似しており,脱退の主な理由は死亡でした.
結論:
- 総合的な高齢者ケアのための専用の高齢者病棟への即時入院は,高齢の股関節骨折患者の移動能力を4ヶ月で大幅に改善しました.
- この発見は,高齢の股関節骨折患者のためのケアを,オートホーゲリアトリックケアとして組織することを支持しています.
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