在社区居住的痴呆症患者中,关节骨折治疗和结果
Rachel R Adler1, Lingwei Xiang1, Samir K Shah2
1Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts.
JAMA network open
|May 30, 2024
概括
在痴呆症患者,特别是中度至重度痴呆症 (MSD) 患者的关节骨折手术治疗,与非手术选择相比,显著降低了180天死亡率. 手术干预没有影响养老院入院.
科学领域:
- 老年学是一门学科.
- 整形外科手术 整形外科手术
- 痴呆症护理 痴呆症护理 痴呆症护理
背景情况:
- 部骨折对社区居住的痴呆症患者构成重大风险.
- 在这个人群中,关节骨折的治疗决策是复杂的,平衡手术风险与非手术结果.
研究的目的:
- 在社区居住的痴呆患者中,将手术治疗与非手术治疗的关节骨折的死亡率和急性后护理结果进行比较.
主要方法:
- 对国家医疗保险服务费用数据 (2017-2018年) 的回顾性,基于人口的分析.
- 包括被诊断患有痴呆症和关节骨折的社区住宿医疗保险受益者.
- 主要结局:30,90和180天死亡率. 二次结果:急性后护理服务.
主要成果:
- 在56209名患者中,59.0%接受了手术治疗.
- 对于中度至重度痴呆症 (MSD) 和大腿骨头/部骨折,180天死亡率为31.8% (手术) 与45.7% (非手术).
- 经过手术治疗的180天死亡率的调整几率比为MSD的0.59 (P < .001),轻度痴呆的0.71 (P < .001).
结论:
- 在MSD和轻度痴呆症患者中,手术治疗关节骨折与较低的180天死亡率有关.
- 手术治疗没有证明在180天内预防养老院入院的好处.
- 调查结果有助于就痴呆患者的关节骨折治疗进行共享决策讨论.
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