Abstract

Summary

Patients hospitalised with vertebral fragility fractures were elderly, multimorbid and frail and lead to poor outcomes. Their hospital treatment needs to consider this alongside their acute fracture. A systematic organised model of care, such as an adaptation of orthogeriatric hip fracture care, will offer a more holistic approach potentially improving their outcomes.

Purpose

Patients admitted to hospital with vertebral fragility fractures are elderly and have complex care needs who may benefit from specialist multidisciplinary input. To date, their characteristics and outcomes have not been reported sufficiently. This study aims to justify such a service.

Methods

Patients admitted with an acute vertebral fragility fracture over 12 months were prospectively recruited from a university hospital in England. Data were collected soon after their admission, at discharge from hospital and 6 months after their hospital discharge on their characteristics, pain, physical functioning, and clinical outcomes.

Results

Data from 90 participants were analysed. They were mainly elderly (mean age 79.7 years), multimorbid (69% had ≥ 3 comorbid condition), frail (56% had a Clinical Frailty Scale score ≥ 5), cognitively impaired (54% had a MoCA score of < 23) and at high risk of falls (65% had fallen ≥ 2 in the previous year). Eighteen percent died at 6 months. At 6 months post-hospital discharge, 12% required a new care home admission, 37% still reported their pain to be severe and physical functioning was worse compared with their preadmission state.

Conclusion

Patients hospitalised with vertebral fragility fractures were elderly, multimorbid, frail and are susceptible to persistent pain and disability. Their treatment in hospital needs to consider this alongside their acute fracture. A systematic organised model of care, such as an adaptation of orthogeriatric hip fracture care, will offer a more holistic approach potentially improving their outcomes.

中文翻译：

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诺丁汉脊柱健康（NoSH）研究：一项住院治疗椎骨脆性骨折患者的队列研究

摘要

概要

椎骨脆性骨折住院的患者年龄较大，多病且虚弱，导致预后不良。他们的医院治疗需要在急性骨折的同时考虑到这一点。系统的，有组织的护理模型，例如对老年性髋骨骨折护理的改编，将提供更全面的方法，有可能改善其疗效。

目的

因椎骨脆性骨折入院的患者年龄较大，需要复杂的护理，这些患者可能会从专业的多学科投入中受益。迄今为止，尚未充分报道其特征和结果。这项研究旨在证明这种服务的合理性。

方法

前瞻性地从英格兰的一家大学医院招募了12个月以上的急性椎骨脆性骨折的患者。入院后，出院时和出院后6个月收集有关其特征，疼痛，身体功能和临床结局的数据。

结果

分析了来自90名参与者的数据。他们主要是老年人（平均年龄79.7岁），多病态（69％≥3合并症），虚弱（56％的临床脆弱量表得分≥5），认知障碍（54％的MoCA得分<23）和跌倒的风险很高（65％的人去年跌倒了≥2）。六个月时有18％的人死亡。出院后6个月，有12％的人需要重新入院，还有37％的人报告他们的疼痛较重，而身体功能与入院前相比更差。

结论

椎骨脆性骨折住院的患者年龄较大，多病，虚弱，易患持续性疼痛和残疾。他们在医院的治疗需要考虑到其急性骨折。系统的，有组织的护理模型，例如矫正老年性髋部骨折的护理，将提供一种更全面的方法，有可能改善其疗效。