老年髋部骨折患者术后康复期跌倒风险与风险感知的差异性

杨嫦; 周敏捷; 凌乐洁; 骆国钢

doi:10.16766/j.cnki.issn.1674-4152.003855

老年髋部骨折患者术后康复期跌倒风险与风险感知的差异性

doi: 10.16766/j.cnki.issn.1674-4152.003855

温州市中西医结合医院创伤骨科，浙江温州 325000

基金项目:

浙江省中医药科技计划项目 2021ZB275

温州市基础性科研项目 Y20220526

详细信息

通讯作者:
杨嫦，E-mail：yangchang03206229@163.com

中图分类号: R683.3
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- 文章访问数: 31
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- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2024-01-08
- 网络出版日期: 2025-02-13

Difference of fall risk and risk perception in elderly patients with hip fracture after operation in rehabilitation period

Department of Traumatology, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的探讨老年髋部骨折患者术后康复期的跌倒风险现状及其不同跌倒风险等级患者的风险感知水平差异。方法采用便利抽样法抽取温州市中西医结合医院2022年1月—2023年8月收治的356例老年髋部骨折术后康复期患者为研究对象。使用一般资料调查问卷收集患者的一般资料，采用跌倒风险量表、跌倒风险感知量表评估患者跌倒风险及跌倒风险感知水平，并分析老年髋部骨折术后患者康复期跌倒风险与风险感知的差异。结果 356例老年髋部骨折术后康复期患者中78例(21.91%)跌倒低风险，88例(24.72%)跌倒中风险，190例(53.37%)跌倒高风险；124例(34.83%)跌倒风险感知为低感知，117例(32.87%)中感知，115例(32.30%)高感知。不同跌倒风险等级老年髋部骨折术后康复期患者跌倒风险感知水平组间比较，差异无统计学意义(P＞0.05)；跌倒低、中、高风险老年髋部骨折术后康复期患者组内跌倒风险感知得分比较，差异均有统计学意义(P＜0.05)；跌倒低风险患者中，高感知占51.28%(40/78)，跌倒中风险患者中，低感知占32.95%(29/88)，跌倒高风险患者中，低感知占67.37%(128/190)。结论老年髋部骨折术后患者康复期跌倒风险较高，且存在跌倒风险及风险感知水平的差异性。
- 髋部骨折 /
- 老年 /
- 康复期 /
- 跌倒 /
- 风险感知
Abstract: Objective To explore the present situation of fall risk of elderly patients with hip fracture in rehabilitation period after operation and the difference of risk perception level among patients with different fall risk levels. Methods A total of 356 elderly patients with hip fracture in rehabilitation period from January 2022 to August 2023 at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine were selected as the research object. The general information of patients was collected by general data questionnaire, and both fall risk and fall risk perception scale were assessed using standardized scales. Differences between the fall risk and risk perception of elderly patients with hip fracture in rehabilitation period were analyzed. Results Among the 356 elderly patients with hip fracture after operation, 78 cases (21.91%) were classified as low risk of falling, 88 cases (24.72%) as middle risk of falling, and 190 cases (53.37%) as high risk of falling. In terms of risk perception, 124 cases (34.83%) had low-perceived, 117 cases (32.87%) had medium-perceived, and 115 cases (32.30%) had high-perceived. There was no significant difference in the overall perception of fall risk among the elderly patients with hip fracture in rehabilitation period after operation (P>0.05). However, there were significant differences in the perception scores of fall risk among the elderly patients with low risk, medium risk, and high risk of hip fracture in the rehabilitation period after operation (P < 0.05). Among patients with low risk of falling, high perception accounted for 51.28% (40/78), while low perception accounted for 32.95% (29/88) among patients with middle risk of falling. In the high-risk group, low perception accounted for 67.37% (128/190). Conclusion Elderly patients with hip fracture have a high risk of falling during rehabilitation, with noticeable differences between the risk of falling and the level of risk perception.
- Hip fracture /
- Old age /
- Rehabilitation period /
- Fall /
- Risk perception

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表 1 不同一般资料老年髋部骨折术后康复期患者跌倒风险、跌倒风险感知水平比较(x±s, 分)

Table 1. Comparison of fall risk and perceived levels in elderly postoperative hip fracture patients during rehabilitation with different general data(x±s, points)

项目	类别	例数	Morse评估量表得分	统计量	P值	跌倒风险感知量表得分	统计量	P值
年龄(岁)	60~70	113	40.29±13.00	18.530^a	< 0.001	64.55±10.83	0.409^a	0.665
	>70~80	167	45.44±10.69			65.56±8.91
	>80	76	50.54±10.62			65.63±9.69
性别	男性	201	44.39±12.64	0.914^b	0.361	63.57±6.85	1.673^b	0.095
	女性	155	45.34±6.65			62.55±4.63
BMI	< 18.5	85	43.28±11.09	1.631^a	0.197	62.83±8.52	2.893^a	0.057
	18.5~23.9	154	45.09±10.21			63.28±8.00
	>23.9	117	42.83±11.50			64.87±10.42
文化程度	初中及以下	187	45.39±5.62	14.740^a	< 0.001	61.53±11.80	6.807^a	0.001
	高中	132	45.34±5.07			65.61±10.89
	大学及以上	37	40.25±5.69			67.54±14.93
婚姻状况	在婚	295	42.27±10.93	1.682^b	0.096	64.86±11.60	1.320^b	0.191
	单身	61	44.97±11.51			62.36±13.82
居住情况	独居	72	39.30±10.45	1.383^b	0.169	65.31±12.60	1.218^b	0.226
	非独居	284	41.29±12.55			67.37±13.64
医疗支付方式	医保	267	40.29±10.51	1.524^b	0.130	62.57±12.81	1.333^b	0.184
	自费	89	42.40±11.57			64.55±11.90
基础疾病	无	36	35.26±7.81	30.820^a	< 0.001	61.83±10.97	1.413^a	0.245
	1~2	94	40.15±9.19			63.36±11.86
	≥3	126	45.83±6.38			65.17±12.72
视力	正常	265	41.85±7.71	2.881^b	0.005	61.54±10.69	1.608^b	0.111
	异常	91	44.57±7.79			64.57±16.85
骨折部位	股骨颈	180	41.74±11.35	1.225^b	0.221	60.83±12.60	1.557^b	0.120
	股骨粗隆间	176	43.32±12.91			62.88±12.24
骨折侧	左侧	162	39.92±12.51	0.296^b	0.767	64.83±11.42	1.062^b	0.289
	右侧	194	40.32±12.92			63.41±13.81
骨折类型	陈旧性骨折	21	44.96±12.44	0.127^b	0.900	65.40±9.29	0.210^b	0.835
	新鲜骨折	335	45.31±9.20			65.85±12.53
手术方式	内固定	196	42.48±11.23	0.585^a	0.558	62.57±11.32	1.779^a	0.170
	股骨头置换	109	43.20±14.01			65.29±14.10
	全髋关节置换	51	44.59±14.44			64.68±14.53
近3个月跌倒史	有	65	58.32±3.50	22.413^b	< 0.001	73.72±10.93	8.824^b	< 0.001
	无	291	42.15±9.83			60.52±10.79
注：^a为F值，^b为t值。

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表 2 不同跌倒风险等级老年髋部骨折术后康复期患者跌倒风险感知水平比较(x±s, 分)

Table 2. Comparison of fall risk perception levels in elderly hip fracture patients at different fall risk levels during rehabilitation(x±s, points)

跌倒风险等级	例数	Morse评估量表得分	跌倒风险感知量表得分
低风险	78	16.32±5.27	59.41±11.71
中风险	88	36.25±7.14	64.52±15.98
高风险	190	56.25±8.33	62.09±16.75
F值		832.100	2.221
P值		< 0.001	0.110

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表 3 不同跌倒风险等级老年髋部骨折术后患者康复期跌倒风险感知水平组内比较

Table 3. Comparison of intra-group differences in fall risk perception among elderly hip fracture patients at various fall risk levels during rehabilitation

跌倒风险等级	例数(%)	跌倒风险感知量表得分(x±s, 分)	F值	P值
低风险			191.567	< 0.001
低感知	10(12.82)	38.34±8.56
中感知	28(35.90)	60.55±4.13
高感知	40(51.28)	76.25±5.91
中风险			249.956	< 0.001
低感知	29(32.95)	47.34±5.20
中感知	40(45.45)	63.62±4.06
高感知	19(21.59)	78.77±5.69
高风险			626.513	< 0.001
低感知	128(67.37)	39.34±6.46
中感知	35(18.42)	62.57±6.02
高感知	27(14.21)	80.78±3.25

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