1.Predictors of the Outcome Destination of Patients with a Proximal Femoral Fracture in a Convalescent Rehabilitation Ward
Yuto KIMURA ; Masakazu MURAKAMI
The Japanese Journal of Rehabilitation Medicine 2023;():23023-
Purpose:This study aimed to clarify the conditions necessary for patients with a proximal femoral fracture in the convalescent ward to return home using a decision tree analysis. This study included 181 patients who were discharged from the convalescent ward between January 2018 and June 2022.Methods:Patients divided into two groups:home vs. facility according to the outcome. Basic characteristics, FIM at admission, and MMSE at admission were compared using the unpaired t-test, χ2 test, and Mann-Whitney U test, and a decision tree analysis was performed.Results:The decision tree analysis based on functional independence measures (FIM) on admission and toileting activities, etc. found that discharge was difficult (return home rate:9.7%-28.6%) when the problem-solving aspect of the FIM on admission was less than 4 points.Conclusion:When discharging patients with a proximal femoral fracture from the hospital, it is important to consider a combination of problem-solving in the admission FIM and toileting activities.
2.Predictors of the Outcome Destination of Patients with a Proximal Femoral Fracture in a Convalescent Rehabilitation Ward
Yuto KIMURA ; Masakazu MURAKAMI
The Japanese Journal of Rehabilitation Medicine 2023;60(12):1097-1104
Purpose:This study aimed to clarify the conditions necessary for patients with a proximal femoral fracture in the convalescent ward to return home using a decision tree analysis. This study included 181 patients who were discharged from the convalescent ward between January 2018 and June 2022.Methods:Patients divided into two groups:home vs. facility according to the outcome. Basic characteristics, FIM at admission, and MMSE at admission were compared using the unpaired t-test, χ2 test, and Mann-Whitney U test, and a decision tree analysis was performed.Results:The decision tree analysis based on functional independence measures (FIM) on admission and toileting activities, etc. found that discharge was difficult (return home rate:9.7%-28.6%) when the problem-solving aspect of the FIM on admission was less than 4 points.Conclusion:When discharging patients with a proximal femoral fracture from the hospital, it is important to consider a combination of problem-solving in the admission FIM and toileting activities.
3.Successful emergency operation for a graft-enteric fistula with massive melena and sepsis: A case report.
Yutaka KOTSUKA ; Jun NAKAJIMA ; Takeshi MIYAIRI ; Ryuji MURAKAMI ; Hideto NAKAHARA ; Masakazu NOBORI ; Yusuke TADA
Japanese Journal of Cardiovascular Surgery 1989;18(6):804-808
A 44-year-old male, with past history of mitral valve re-replacement, tricuspid annuloplasty and re-replacement of aorto-biiliac prosthetic graft 4 years previously, was admitted to Asahi General Hospital because of massive melena, sepsis and shock. Angiography revealed a false aneurysm at the site of the anastomosis between the graft and the right external iliac artery. He was diagnosed as having graft-enteric fistula, and the emergency operation, including partial resection of the graft, excision of the false aneurysm and extraanatomic bypass, was performed successfully. Pathogenesis, diagnosis and treatment of graft-enteric fistula are discussed.


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