大腿骨近位部骨折術後患者における夜間の排泄関連動作再獲得の関連要因

Factors associated with reacquisition of nocturnal voiding-related movements in postoperative hip fracture patients

要旨：回復期リハビリテーション病棟へ入院した大腿骨近位部骨折術後患者130例（女性105例，平均年齢82.1±7.8歳）において，退院時の夜間の排泄関連動作の自立の可否とその関連要因を調査した．その結果，退院時に夜間排泄関連動作が自立した者は96例（73.8％）で，自立の可否にてロジスティック回帰分析をおこない，入院時において日常生活活動動作，認知機能，バランス能力が高いこと，失禁を有さないことが有意な因子として抽出された．入院時点で退院時の夜間排泄関連動作の自立の可否を予測することで，機能回復だけでなく介助指導の必要性やタイミングを検討し，早期からの円滑な在宅移行支援が可能になると考えられた．

　In this prospective study, we investigated whether 130 patients (105 females, mean age 82.1±7.8 years) admitted to our hospital after hip fracture surgery were independent in nighttime excretion-related activities at the time of discharge from the hospital and the factors associated with such independence. The results of this study showed that 96 patients (73.8%) were independent in nighttime excretion-related activities at the time of hospital discharge. Logistic regression analysis was performed to determine the degree of independence, and the following factors were identified as significant : higher score of activities of daily living, higher cognitive function, higher balance function, and no incontinence. Prediction of the patients' independence in nighttime excretion-related activities at the time of hospitalization enables us to consider not only functional recovery, but also the necessity and timing of care guidance and support for smooth home transition from the early stage.