Significant changes in the surgical methods and length of hospital stay of hip fracture patients occurring over 10 years in Central Finland.

Annales chirurgiae et gynaecologiae Pub Date : 1999-01-01
T Huusko, P Karppi, V Avikainen, H Kautiainen, R Sulkava
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Abstract

Background and aims: The objective of this study is to determine the changes occurring in the treatment chain and mortality of hip fracture patients in Central Finland over a ten-year period. In order to cope with an aging population and increasing cutbacks in the health care system, health-center hospitals run by general practitioners have taken a more active role in the rehabilitation of elderly patients.

Material and methods: Patients with acute hip fracture admitted to Jyväskylä Central Hospital in 1982-1983 (n = 317) and in 1992-1993 (n = 351) were collected from the hospital discharge register and the medical records of these patients were studied retrospectively.

Results: The median length of central hospital stay diminished from 18 days to 5 days and the percentage of hip fracture patients discharged to cope on their own diminished from 22 % to only 7 %. The percentage of trochanteric fractures treated by osteosynthesis increased from 83 % to 96 % and the percentage of cervical fractures treated by hemiprosthesis increased from 35 % to 76 %. First-year mortality has remained almost unchanged.

Conclusions: There has been a dramatic change in surgical methods, in the length of hospital stay on the traumatology ward, and in discharge patterns and no change in mortality during the last 10 years in Central Finland.

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芬兰中部10年以上髋部骨折患者手术方法和住院时间的显著变化
背景和目的:本研究的目的是确定十年来芬兰中部髋部骨折患者治疗链和死亡率的变化。为了应对人口老龄化和医疗保健系统的不断削减,全科医生经营的健康中心医院在老年患者的康复中发挥了更积极的作用。材料与方法:收集Jyväskylä中心医院1982-1983年收治的急性髋部骨折患者(317例)和1992-1993年收治的急性髋部骨折患者(351例),对其病历进行回顾性分析。结果:中心住院时间的中位数从18天减少到5天,髋部骨折患者自行出院的比例从22%减少到7%。股骨粗隆骨折采用骨融合术的比例从83%增加到96%,颈椎骨折采用半假体术的比例从35%增加到76%。第一年的死亡率几乎保持不变。结论:在过去10年中,芬兰中部的手术方法、创伤病房住院时间和出院模式发生了巨大变化,死亡率没有变化。
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