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Outcomes bei Alterstrauma

Outcome assessment in geriatric trauma

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Zusammenfassung

Die Zahl älterer Patienten mit Fragilitätsfrakturen nimmt stetig zu. Die Berücksichtigung relevanter funktioneller Einschränkungen und Komorbiditäten ist bei dieser Patientengruppe von großer Bedeutung für die Behandlungsstrategie und die Beurteilung des Behandlungsergebnisses. Aus diesem Grund erscheint die routinemäßige Einführung eines geriatrischen Basisassessments in jeder orthopädisch-traumatologischen Abteilung sinnvoll. Bei der Analyse der Ergebnisse nach den häufigen Fragilitätsfrakturen (Hüfte, Radius) sollten Instrumente zum Einsatz kommen, die die verschiedenen Komponenten der Internationalen Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit (ICF) abbilden: neben Methoden zur Messung der Schädigung von Körperfunktionen und -strukturen bieten sich Analysen zur Abschätzung der Beeinträchtigung der Aktivitäten und der Partizipation an. Hierbei erscheint der kombinierte Einsatz krankheits- bzw. körperregionenspezifischer Scores mit generischen Scores empfehlenswert. Zudem kann es sinnvoll sein, Instrumente zur gesundheitsökonomischen Analyse einzusetzen.

Abstract

The number of elderly and old patients with fractures is steadily increasing. Identification of relevant functional deficits and comorbidities is crucial for an efficient treatment strategy and outcome assessment in this patient group. For this reason the integration of a geriatric assessment in every orthopedic traumatology practice seems recommendable. Assessing the outcome of frequent fragility fractures (hip, radius) requires instruments oriented to the International Classification of Functioning, Disability and Health (ICF) which allow analysis of bodily function and structure as well as activity and participation. A combination of disease and body region-specific scores with generic scores seems to be reasonable. It can also be sensible to include instruments for health economic analyses.

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Authors and Affiliations

  1. Abt. Orthopädie und Unfallchirurgie, Medical Park Berlin Humboldtmühle, An der Mühle 2–9, 13507, Berlin, Deutschland

    K.E. Dreinhöfer

  2. Institut für muskuloskelettale Rehabilitation, Prävention und Versorgungsforschung, Centrum für Sportwissenschaften und Sportmedizin (CSSB), Centrum für Muskuloskeletale Chirurgie (CMSC), Charité, Universitätsmedizin Berlin, Berlin, Deutschland

    K.E. Dreinhöfer

  3. Klinik und Poliklinik für Physikalische Medizin und Rehabilitation, Klinikum der Ludwig-Maximilians-Universität München, Campus Großhadern, München, Deutschland

    S.R. Schwarzkopf

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Correspondence to K.E. Dreinhöfer.

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Dreinhöfer, K., Schwarzkopf, S. Outcomes bei Alterstrauma. Unfallchirurg 113, 462–468 (2010). https://doi.org/10.1007/s00113-010-1746-3

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