Procena uticaja snage stiska šake kao prediktora rehabilitacionog ishoda kod pacijenata sa prelomom kuka
Assessment of handgrip strength as a predictor of rehabilitation outcome in hip fracture patients
Author
Selaković, IvanMentor
Dubljanin-Raspopović, EmilijaCommittee members
Marković-Denić, LjiljanaKadija, Marko
Maksimović, Nataša
Tomašević-Todorović, Snežana
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Show full item recordAbstract
Prelomi kuka su globalni problem koji često rezultuje lošim zdravstvenim ishodima i
visokim troškovima zdravstvene zaštite. Predviđanje rehabilitacionih ishoda kod pacijenata nakon
preloma kuka je ključno pitanje za optimizaciju rehabilitacionih protokola, definisanje optimalne
raspodele resursa i organizacije nege.
Cilj ovog istraživanja je bio određivanje prediktora uspešnosti oporavka starijih pacijenata
nakon operativno lečenog preloma kuka. Među ispitivanim prediktorima poseban cilj je bio da se
proceni povezanost snage stiska šake merene rano nakon preloma kuka i klasifikovane prema
ERGSS2 kriterijumima i drugih ulaznih varijabli, kao i njena uloga u predikciji kratkoročnog i
dugoročnog mortaliteta, funkcionalnog oporavka i kvaliteta života u ovoj grupi isptianika.
Praćen je 191 pacijent stariji od 65 godina nakon preloma kuka, koji je operisan na Klinici
za ortopedsku hirurgiju i traumatologiju Kliničkog centra Srbije u periodu od 1.marta 2017. do
1.septembra 2018. godine. Prose...čna starost ispitanika je bila 80,3±6,8 godina. Među ispitanicima
35% je imalo slabost snage stiska šake. Ovi pacijenti su bili značajno stariji, češće ženskog pola,
imali su manji indeks telesne mase i bili su lošijeg zdravstvenog statusa. Pacijenti sa slabijim
stiskom šake su takođe imali lošiji kognitivni status, manje vrednosti Bartelovog indeksa i lošiji
kvalitet života pre preloma. Multivarijantna regresiona analiza pokazala je da je slabost snage
stiska šake bila nezavisni prediktor aktivnosti dnevnog života 6 meseci nakon preloma kuka. Snaga
stiska šake je takođe bila povezana sa nižim tromesečnim vrednostima aktivnosti dnevnog života,
kao i tro- i šestomesečnim mortalitetom, vrednostima instrumentalizovanih aktivnosti dnevnog
života, kvaliteta života, ali nije bila i njihov nezavisni prediktor.
Rezultati našeg istraživanja podržavaju značaj ispitivanja snage stiska šake u akutnoj fazi u
sklopu multidimenzionalne procene oporavka pacijenata sa prelomom kuka.
Hip fractures are a global concern, often resulting in poor health outcomes and high health
care costs. Predicting the rehabilitation outcomes of hip fracture patients is a crucial issue to
optimize rehabilitation protocols, define optimal resources allocation and care organization.
This investigation aimed to determine predictors of short- and long-term recovery of elderly
patients after surgically treated hip fractures. Among the predictors examined, the specific
objective was to evaluate the association of handgrip strength measured early after hip fracture
and classified according to the EWGSOP2 criteria and other baseline variables, as well as its role
in the prediction of short- and long-term mortality, functional recovery, and quality of life.
One hundred ninety-one patients older than 65 years with acute hip fractures who were
surgically treated at the Clinic for Orthopedic Surgery and Traumatology, Clinical Canter of Serbia
in the period 1.3.2017- 1.9.2018. were examined. The ...mean age of the participants was 80.3±6.8
years. Among the participants, 35% had a weakness of the hand grip strength. These patients were
significantly older, more often female, had a lower body mass index, and were of worse physical
health. They also had a lower cognitive level, lower Barthel index, and lower quality of life before
fracture. Multivariate regression analysis revealed that hand grip weakness was an independent
predictor of activites of daily living 6 months after hip fracture. Hand grip strength was also
associated with lower indipendence three-month postoperatively regarding activities of daily
living, as well as instrumentalized activities of daily living, quality of life, and three- and sixmonth
mortality, but was not their independent predictor.
The results of our study support the importance of examining hand grip strength in the acute
phase as part of a multidimensional assessment of the recovery of patients with hip fractures.