ELDERLY PATIENTS WITH HIP-FRACTURES - IMPROVED OUTCOME WITH THE USE OF CARE MAPS WITH HIGH-QUALITY MEDICAL AND NURSING PROTOCOLS

被引：53

作者：

OGILVIEHARRIS, DJ

BOTSFORD, DJ

HAWKER, RW

机构：

[1] Division of Orthopaedic Surgery, The Toronto Hospital and University of Toronto, Toronto, ON

来源：

JOURNAL OF ORTHOPAEDIC TRAUMA | 1993年 / 7卷 / 05期

关键词：

HIP FRACTURE; CARE MAP;

D O I：

10.1097/00005131-199310000-00005

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

In a prospective cohort study, 51 patients were treated with standard nursing and medical treatment after sustaining a hip fracture. A second group of 55 patients was treated with high-quality medical and nursing protocols outlined on our care map. The patient groups showed no significant differences preoperatively in terms of the important variables of age, mental status, marital status, accommodation, ambulation, fracture type or fracture treatment. Postoperatively the patients were followed for a 6-month outcome. The outcome of return to their place of accommodation and their previous level of function was considered grade 1. In grade 2, the patients lost one level of function or one level of accommodation. In grade 3 they lost one level of accommodation and one level of function. In grade 4 they were dead. Overall we were able to show that the patients in the study group had a statistically significantly better outcome (p = 0.036). In addition, they had significantly fewer postoperative complications (p = 0.01) and a significantly greater number of the patients returned home within 14 days of their admission. We feel that the medical and nursing protocols outlined are generally applicable and could significantly improve the outcome overall for elderly patients with fractured hips.

引用

页码：428 / 437

页数：10

共 45 条

[31]

Lord S.R., Sinnett P.F., Femoral neck fractures: Admissions, bed use, outcome and projections, Med J Aust, 145, pp. 493-496, (1986)

[32]

McCabe M., From disease to delirium: Managing the declining elderly patient, Geriatrics, 45, pp. 28-31, (1990)

[33]

Miller C.W., Survival and ambulation following hip fracture, J Bone Joint Surg [Am], 60, pp. 930-934, (1978)

[34]

Moore D.P., Quinlan W., Mortality and morbidity association with fractures, Ir J Med Sci, 158, pp. 40-42, (1989)

[35]

National Health Center for Health Statistics, Advance Data from Vitaland Health Statistics: 1985 Summary: Nutritional Hospital Discharge Summary, (1986)

[36]

Nelson L., Taylor F., Adams M., Parker D., Improving pain management for hip fractured elderly, Orthop Nurs, 3, pp. 79-83, (1990)

[37]

Olivas G.S., Del Togno-Armanasco V., Erickson J.R., Harter S., Case management: A bottom-line care delivery model, J Nurs Adm, 19, pp. 16-20, (1989)

[38]

Porter R.W., Miller C.B., Grainger D., Palmer S.B., Prediction of hip fracture in elderly women: A prospective study, Br Med J, 301, pp. 638-641, (1990)

[39]

Pryor G.A., Williams D.R.R., Rehabilitation after hip fractures, J Bone Joint Surg [Br], 71, pp. 471-474, (1989)

[40]

Sikorski J.M., Davis N.J., Senior J., The rapid transit system for patients with fracture of the proximal femur, Br Med J, 290, pp. 439-443, (1985)

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