痴呆症对关节骨折患者的影响
Andrei Vlad Bradeanu1,2, Iulian Bounegru2,3, Loredana Sabina Pascu2,4
1Department of Orthopedy and Traumatology, Saint Apostle Andrew Emergency County Clinical Hospital, Galati, Romania.
Discoveries (Craiova, Romania)
|September 26, 2024
概括
患有痴呆症的老年患者的部骨折存在重大疼痛管理挑战. 这些患者的手术干预,尽管死亡率很高,但与非手术选择相比,通常会导致更好的疼痛控制和生存.
科学领域:
- 老年医学 老年医学
- 整形外科手术 整形外科手术
- 神经学 神经学
背景情况:
- 关节骨折是老年人发病和死亡的主要原因.
- 痴呆症患者在疼痛评估和管理方面遇到独特的挑战.
- 伴随性疾病进一步使老年人部骨折的治疗决策更加复杂.
研究的目的:
- 改进对患有痴呆症的关节骨折患者的疼痛评估和管理策略.
- 为了确定最佳的治疗方法,考虑到年龄,并发病症和痴呆症的严重程度.
- 分析手术治疗患者与非手术治疗患者的死亡率和生存率.
主要方法:
- 在184名痴呆症和部骨折患者 (60岁以上) 的前性研究 (2018-2020年).
- 使用查尔森并发症指数,ACE III,EQ5D5L和哈里斯分数进行评估.
- 评估疼痛水平,日常活动,自我护理,痴呆症严重程度和并发症.
主要成果:
- 没有手术的患者报告了更严重的疼痛和更高的不移性.
- 经过手术的患者通常经历了较低的疼痛水平和改善的移动性.
- 死亡率在6个月和2年仍然很高,但手术治疗组的生存率更好.
- 伴随性疾病,痴呆症的严重程度和晚年是死亡率的重要风险因素.
结论:
- 尽管存在风险,但在痴呆症患者的部骨折中进行手术干预可以提供更好的疼痛管理和生存结果.
- 术前精神状态评估对于治疗决策至关重要.
- 疼痛控制,特别是在痴呆症患者的术前和术后阶段,需要专门的注意.
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