首页|《国际功能、残疾和健康分类康复组合》在股骨骨折患者康复结局评价中的应用

《国际功能、残疾和健康分类康复组合》在股骨骨折患者康复结局评价中的应用

扫码查看
目的 探讨《国际功能、残疾和健康分类康复组合》(ICF-RS)在股骨骨折患者康复结局评价中的应用.方法 选取2022年1月—2023年5月在广东祈福医院骨科中心就诊的股骨骨折患者29例,分别于术前(入院时)、术后(术后第2天)及康复后(出院时)采用ICF-RS APP和临床功能检查评估患者身体功能、活动功能、参与功能和整体功能障碍情况;比较ICF-RS APP人工智能模型预测与评估者评价功能等级一致性;分析患者住院期间的各项医疗费用支出(手术费用、药物费用、康复费用、检查费用、其他费用)和功能改善率.结果 ICF-RS评定结果显示,患者术前和术后均以重度功能障碍为主,术后身体功能障碍程度较术前加重,主要表现在类目b620(排尿功能)、类目b455(运动耐受能力)及b710(关节活动能力).康复后患者在身体、活动和参与功能以及整体功能表现为重度功能障碍的类目均有改善(P<0.05).人工智能模型预测与评估者评价功能等级在身体功能、活动功能、参与功能3个维度及整体功能Kappa系数均>0.9.患者平均住院时间(29.5±12.1)d,平均支出医疗费用(55 930.1±21 440.5)元,其中平均支出康复费用(8 168.7±5 817.4)元,平均支出康复费用占平均支出医疗费用13.7%.康复后,整体功能改善率≥35%共19例(65.52%),功能障碍每改善1%,其平均支出医疗费1 598元,其中平均支出康复费用233元.结论 ICF-RS能较好反映股骨骨折患者身体、活动和参与功能,ICF-RS人工智能模型预测与评估者评价功能等级一致性较好.
Application of the International Classification of Functioning,Disability and Health Rehabilita-tion Set for Evaluation of Rehabilitation Outcomes of Patients with Femoral Fracture
Objective To explore the application of the International Classification of Functioning,Disability and Health Re-habilitation Set(ICF-RS)for evaluation of rehabilitation outcomes of patients with femoral fracture.Methods A total of 29 patients with femoral fracture in the Orthopedic Center of Guangdong Clifford Hospital from January 2022 to May 2023 were recruited.The ICF-RS mobile APP and clinical function examinations were used to evaluate the body function,activity function,participation func-tion and overall dysfunction before surgery(at admission),after surgery(the second day after operation)and after recovery(at dis-charge),respectively.The consistency between the ICF-RS mobile APP's artificial intelligence model prediction and the evaluators'function level assessments was compared.The medical expenses(surgical costs,medication costs,rehabilitation costs,examination costs and other costs)and the rate of functional improvement during hospitalization were analyzed.Results The ICF-RS evalua-tion results showed that patients had predominantly severe functional disabilities before and after surgery,and the degree of physical disabilities after surgery was worse than that before surgery,mainly manifested in categories b620(urination function),b455(exer-cise tolerance)and b710(joint mobility).Patients showed improvements in body,activity,participation and overall functions,with a significant reduction in the categories of severe functional disabilities after rehabilitation(P<0.05).The Kappa coefficients of the ar-tificial intelligence model prediction and the evaluators'assessments across the three dimensions of body function,activity function,and participation function,as well as overall function were all greater than 0.9.The average hospital stay was(29.5±12.1)days,and the average total medical expenses were(55 930.1±21 440.5)yuan,of which the average rehabilitation expenses were(8 168.7±5 817.4)yuan,accounting for 13.7%of the average total medical expenses.The overall functional improvement rate was≥35%(19 cases,65.52%)after rehabilitation.For each 1%improvement in functional disability,the average medical expenditure was 1 598 yuan,of which the average rehabilitation expenditure was 233 yuan.Conclusion The ICF-RS can be used to evaluate the body,activity and participation functions of patients with femoral fracture,and the ICF-RS artificial intelligence model prediction has a good consistency with the evaluators'assessments of functional levels.

femoral fracturerehabilitation outcome evaluationInternational Classification of Functioning,Disability and Health Rehabilitation Set

江潭耀、许秀、燕铁斌、李涛、于娜、陈向阳、张欣婷、张忠平

展开 >

暨南大学祈福医院,广东 广州 511495

广东祈福医院,广东 广州 511495

中山大学孙逸仙纪念医院,广东 广州 510120

股骨骨折 康复结局评价 国际功能、残疾和健康分类康复组合

2024

康复学报
福建中医药大学

康复学报

CSTPCD
影响因子:0.545
ISSN:2096-0328
年,卷(期):2024.34(6)