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Rehabilitation Practice and Science

Translated Title

台灣老年髖骨骨折病患特色分析以及術後住院期間復健治療之使用狀況

Abstract

Purpose: Among elderly patients, hip fracture is a common clinical problem after falling. Associated complications after hip fracture surgery increase the risk of readmission. The purpose of this article is to analyze the characteristics of elderly hip fracture patients in Taiwan and rehabilitation utilization after hip surgery during admission. We also investigated the comorbidity of hip fracture. We hope to provide information to the clinician for further medical decision making. Materials and Methods: We analyzed patients older than 65 years who received hip fracture surgery from 2000 to 2009 (n = 146405) from the Taiwan’s National Health Insurance Research Database (NHIRD). We defined patients undergoing post-operative rehabilitation during admission as the intervention group (n = 48146) and those who did not receive interventions as the control group (n = 98259). We compared age, gender, fracture type, operation type and comorbidities between the groups. Results: In our study, most hip fracture patients older than 65 years were women (61.6%) and intertrochanteric fractures were the most common type (50.23%). The number of patients with femoral neck fracture in the intervention group is more than that in the control group (51.99% vs. 49.12%, p ＜ 0.0001). In addition, internal fixation surgery (n = 89487) was the main type of surgery (61.12%); post-operative rehabilitation rate during admission was higher among the patients with arthroplasty compared to the control group (43.72% vs. 38.13%, p＜0.0001). The intervention and control groups exhibited no difference in mean Charlson comorbidity index (CCI) (1.22 ± 2.02 vs. 1.22 ± 2.07, p = .9859). Diabetes mellitus, cerebrovascular disease and chronic pulmonary disease were the most common comorbidities. Among the intervention group, the patients who had diabetes mellitus, congestive heart failure, cerebrovascular disease, and hemiplegia or paraplegia were likely to undergo rehabilitation after hip fracture during admission. Patients with chronic pulmonary disease, peripheral vascular disease and dementia were less likely to receive post-operative rehabilitation during admission. Conclusion: Among elderly patients with hip fracture, most of them were females or aged 75 to 85 years. The most common comorbidities were diabetes mellitus, cerebrovascular disease, and chronic pulmonary disease. Patients with arthroplasty, diabetes mellitus, congestive heart failure, cerebrovascular disease, and hemiplegia or paraplegia were likely to undergo rehabilitation after hip fracture during admission. This study therefore can provide information in medical decision making to clinicians for understanding the characteristics of elderly hip fracture patients and utilization of postoperative rehabilitation services during admission in Taiwan.

Language

Traditional Chinese

First Page

63

Last Page

68

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