ABSTRACT
Antecedentes y objetivoLa fractura osteoporótica de cadera es una enfermedad relevante por su prevalencia e impacto social y sanitario. El objetivo de este estudio es explorar la validez predictiva del cuestionario CUPAX sobre la mortalidad, el lugar de residencia y la funcionalidad posfractura.Materiales y métodosEstudio observacional prospectivo. Se incluyeron 206 pacientes mayores de 65 años ingresados tras una fractura de cadera. Se recogió la puntuación del cuestionario CUPAX prefractura y al año, y el lugar de residencia y la supervivencia al alta hospitalaria y a los 6 y 12 meses. El análisis estadístico se ha realizado con los programas SAS® 9.4 y Stata® 13.1.ResultadosLa edad mediana de la muestra fue 87 años (80,1% mujeres). La tasa de mortalidad intrahospitalaria y al año fue del 5,8% y 19,1%, respectivamente. La mayoría de los pacientes procedían de su domicilio (71,4%), y el destino al alta más frecuente fue un centro sociosanitario (48,2%). El porcentaje de retención del nivel funcional previo en el total de la muestra fue del 50%, siendo mayor en los pacientes más jóvenes. El área bajo la curva ROC para la mortalidad al año fue 0,697 (IC 95%: 0,626-0,760) y para el destino al alta de los pacientes procedentes del domicilio 0,659 (IC 95%: 0,576-0,741). La valoración de la retención funcional al año permite identificar 3 grupos de pacientes en función del valor del CUPAX prefractura.ConclusionesEstos hallazgos apoyan la utilidad clínica del cuestionario CUPAX como herramienta funcional predictiva en pacientes ancianos afectos de fractura de cadera.
Subject(s)
Humans , Aged , Hip Fractures , Hospitalization , Osteoporotic Fractures , Aged , Retrospective Studies , Surveys and Questionnaires , PrognosisABSTRACT
BACKGROUND AND OBJECTIVES: Osteoporotic hip fracture is a relevant pathology due to its prevalence and social and health impact. The aim of this study is to explore the predictive validity of the CUPAX questionnaire on mortality, place of residence and post-fracture functionality. MATERIALS AND METHODS: Prospective observational study. Two hundred and six patients older than 65 years were included, admitted after a hip fracture. The CUPAX questionnaire score was collected before fracture and one year later, and the place of residence and survival at hospital discharge, and after 6 and 12 months. The statistical analysis was carried out with the SAS® 9.4 and Stata® 13.1 programmes. RESULTS: The median age of the sample was 87.0 years (80.1% women). The in-hospital and one-year mortality rate were 5.8% and 19.1%, respectively. Most of the patients were admitted from home (71.4%), and the most frequent discharge destination was a social health centre (48.2%). The percentage of retention of previous functional level in the total sample was 50%, being higher in the younger patients. The area under the curve ROC for mortality one year later was .697 (95% CI .626-.760) and .659 (95% CI .576-.741) for the discharge destination of patients admitted from home. Evaluation of functional retention one year after the fracture, identified three groups of patients based on the pre-fracture CUPAX value. CONCLUSIONS: These findings support the clinical utility of the CUPAX questionnaire as a predictive functional tool in elderly patients with hip fracture.
Subject(s)
Hip Fractures , Osteoporotic Fractures , Aged , Aged, 80 and over , Female , Hospitalization , Humans , Male , Prospective Studies , Surveys and QuestionnairesABSTRACT
ANTECEDENTES Y OBJETIVO: Las fracturas de cadera en pacientes ancianos tienen una elevada frecuencia y morbimortalidad. No disponemos de instrumentos validados en castellano que puedan valorar fielmente la capacidad funcional previa a la fractura. El objetivo de este estudio fue desarrollar y validar el cuestionario CUPAX en pacientes ancianos con fractura de cadera. MATERIALES Y MÉTODOS: Estudio de validación observacional y prospectivo. Se incluyó a 215 pacientes mayores de 65 años, que ingresaron en nuestro centro tras sufrir una fractura de cadera. Se evaluaron mediante el cuestionario CUPAX, índice de Barthel y score de Parker. Se realizó el estudio estadístico para valorar la validez y fiabilidad del cuestionario. RESULTADOS: La edad mediana de la muestra fue 84 años (75,3% mujeres). La mayoría de los pacientes presentaban fractura de localización extracapsular, eran previamente deambulantes y sufrían la caída en su domicilio. El estudio estadístico sobre la validez y la fiabilidad del cuestionario obtuvo los siguientes resultados. El coeficiente alfa de Cronbach mostró una excelente consistencia interna (valor de 0,94). El análisis factorial mostró 3 factores subyacentes. El coeficiente de correlación intraclase (CCI) interobservador fue 0,82 (IC del 95%: 0,75-0,87) y el CCI intraobservador fue 0,96 (IC del 95%: 0,95-0,97). La correlación con otras escalas funcionales fue valorada mediante el coeficiente de correlación de Spearman: 0,83 con el índice de Barthel y 0,81 con el score de Parker. CONCLUSIONES: Estos hallazgos apoyan la validez del cuestionario CUPAX como herramienta de valoración del nivel funcional previo en pacientes ancianos afectados de fractura de cadera
BACKGROUND AND AIM: Hip fractures in elderly patients are very frequent and are associated with high morbidity and mortality. We do not have validated instruments in Spanish that can faithfully assess functional capacity prior to fracture. The aim of this study was to develop and validate the CUPAX questionnaire in elderly patients with a hip fracture. MATERIALS AND METHODS: Prospective and observational validation study. We included 215 patients older than 65 years, who were admitted to our centre after suffering a hip fracture. They were evaluated using the CUPAX questionnaire, Barthel Index and Parker Score. The statistical study was performed to corroborate the validity and reliability of the questionnaire. RESULTS: The median age of the patient population was 84.0 years (75.3% women). The majority were patients who had suffered an extracapsular fracture; they had walking capacity and suffered a fall in their place of residence. The statistical analysis on the validity and reliability of the questionnaire obtained the following results: Cronbach's alpha coefficient showed excellent internal consistency (value of .94). Factor analysis showed 3 underlying factors. The interobserver intraclass correlation coefficient (ICC) was .82 (95% CI:.75-.87), and the intraobserver ICC was .96 (95% CI:.95-.97). Correlation with other functional scales was assessed using the Spearman correlation coefficient, which was .83 with the Barthel Index and .81 with the Parker score. CONCLUSIONS: These findings support the validity of the CUPAX questionnaire as a tool to measure the previous functional level in elderly patients affected by a hip fracture
Subject(s)
Humans , Middle Aged , Aged , Aged, 80 and over , Hip Fractures/epidemiology , Physical and Rehabilitation Medicine/methods , Injury Severity Score , Indicators of Morbidity and Mortality , Surveys and Questionnaires , Prospective Studies , Repertory, Barthel , Factor Analysis, StatisticalABSTRACT
BACKGROUND AND AIM: Hip fractures in elderly patients are very frequent and are associated with high morbidity and mortality. We do not have validated instruments in Spanish that can faithfully assess functional capacity prior to fracture. The aim of this study was to develop and validate the CUPAX questionnaire in elderly patients with a hip fracture. MATERIALS AND METHODS: Prospective and observational validation study. We included 215 patients older than 65 years, who were admitted to our centre after suffering a hip fracture. They were evaluated using the CUPAX questionnaire, Barthel Index and Parker Score. The statistical study was performed to corroborate the validity and reliability of the questionnaire. RESULTS: The median age of the patient population was 84.0 years (75.3% women). The majority were patients who had suffered an extracapsular fracture; they had walking capacity and suffered a fall in their place of residence. The statistical analysis on the validity and reliability of the questionnaire obtained the following results: Cronbach's alpha coefficient showed excellent internal consistency (value of .94). Factor analysis showed 3 underlying factors. The interobserver intraclass correlation coefficient (ICC) was .82 (95% CI:.75-.87), and the intraobserver ICC was .96 (95% CI:.95-.97). Correlation with other functional scales was assessed using the Spearman correlation coefficient, which was .83 with the Barthel Index and .81 with the Parker score. CONCLUSIONS: These findings support the validity of the CUPAX questionnaire as a tool to measure the previous functional level in elderly patients affected by a hip fracture.
Subject(s)
Hip Fractures , Aged , Aged, 80 and over , Factor Analysis, Statistical , Female , Humans , Male , Prospective Studies , Reproducibility of Results , Surveys and QuestionnairesABSTRACT
Acute spinal cord injury leaves patients severely impaired and generates high levels of psychological distress among them and their families, which can cause a less active role in rehabilitation, worse functional recovery, and less perceived satisfaction with the results. Additionally, rehabilitation professionals who deal with this psychological distress could ultimately experience higher stress and more risk of burnout. This article presents the study protocol of the ESPELMA project, aimed to train rehabilitation professionals in the clinical management of acute spinal cord injury-associated psychological distress, and to measure the impact of this training on the patients' perceived satisfaction with treatment.
