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Titre : | Clinical Prediction Rule for Declines in Activities of Daily Living at 6 Months After Surgery for Hip Fracture Repair (2016) |
Auteurs : | Ryo Tanaka ; Takuya Umehara ; Takafumi Fujimura |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (2016/12, 2016) |
Article en page(s) : | pp. 20762084 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Activités de la vie quotidienne ; Pronostic ; Rééducation et réadaptation |
Mots-clés: | Activities of daily living ; Hip fractures ; Fractures de la hanche ; Prognosis |
Résumé : |
Objectives To develop and assess a clinical prediction rule (CPR) to predict declines in activities of daily living (ADL) at 6 months after surgery for hip fracture repair. Design Prospective, cohort study. Setting From hospital to home. Participants Patients (N=104) with hip fractures after surgery. Interventions Not applicable. Main Outcome Measure ADL were assessed using the Barthel Index at 6 months after surgery. Results At 6 months after surgery, 86 patients (82.6%) were known to be alive, 1 patient (1.0%) had died, and 17 (16.3%) were lost to follow-up. Thirty-two patients (37.2%) did not recover their ADL at 6 months after surgery to levels before fracture. The classification and regression trees methodology was used to develop 2 models to predict a decline in ADL: (1) model 1 included age, type of fracture, and care level before fracture (sensitivity=75.0%, specificity=81.5%, positive predictive value=70.6%, positive likelihood ratio=4.050); and (2) model 2 included the degree of independence 2 weeks postsurgery for ADL chair transfer, ADL ambulation, and age (sensitivity=65.6%, specificity=87.0%, positive predictive value=75.0%, positive likelihood ratio=5.063). The areas under the receiver operating characteristic curves of both CPR models were .825 (95% confidential interval, .728.923) and .790 (95% confidence interval, .683.897), respectively. Conclusions CPRs with moderate accuracy were developed to predict declines in ADL at 6 months after surgery for hip fracture repair. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999316304142 |