論文

査読有り 国際誌
2019年1月

Inadequate Postoperative Energy Intake Relative to Total Energy Requirements Diminishes Acute Phase Functional Recovery From Hip Fracture.

Archives of physical medicine and rehabilitation
  • Tatsuro Inoue
  • ,
  • Shogo Misu
  • ,
  • Toshiaki Tanaka
  • ,
  • Hiroki Sakamoto
  • ,
  • Kentaro Iwata
  • ,
  • Yuki Chuman
  • ,
  • Rei Ono

100
1
開始ページ
32
終了ページ
38
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.apmr.2018.06.012

OBJECTIVE: To investigate whether postoperative voluntary energy intake (EI) affects functional recovery with hip fracture during the acute phase. DESIGN: Prospective cohort study. SETTING: Three acute care hospitals. PARTICIPANTS: Hip fracture patients (N=200) who were consecutively admitted to 3 acute hospitals because of falling. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Patients were stratified into 3 groups based on the ratio of measured EI to estimated total energy expenditure (TEE) as inadequate (EI/TEE<0.7), intermediate (0.7≤EI/TEE<1), and adequate (EI/TEE≥1) groups. The functional status was evaluated using the motor domain of a FIM. We calculated efficiency based on the motor FIM scores (change in postoperative motor FIM scores/length of the rehabilitation period) to assess the beneficial effect of rehabilitation. RESULTS: The median hospital stay was 24 days. The inadequate group comprised 73 (36.5%) patients (median EI/TEE, 0.54; interquartile range, 0.42-0.64); intermediate group comprised 92 (46.0%) patients (median EI/TEE, 0.87; interquartile range, 0.78-0.94), and adequate group comprised 35 (17.5%) patients (median EI/TEE, 1.10; interquartile range, 1.04-1.15). Absolute functional gain (AFG) and efficiency of motor FIM gain (EFG) scores were higher in the adequate group than in the others (P<.01). After adjustment for potential confounders, a significant association between postoperative EI/TEE group and logarithm of EFG scores was observed to persist (inadequate group, standardized β =-0.14; reference: adequate group; P=0.03; R2 for the entire model =0.25). CONCLUSIONS: Postoperative EI that is less than 70% of TEE diminishes functional recovery with hip fracture.

リンク情報
DOI
https://doi.org/10.1016/j.apmr.2018.06.012
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/30585154

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