康复学报 (Dec 2024)
Application of the <italic>International Classification of Functioning, Disability and Health Rehabilitation Set</italic> for Evaluation of Rehabilitation Outcomes of Patients with Femoral Fracture
Abstract
ObjectiveTo explore the application of the International Classification of Functioning, Disability and Health Rehabilitation Set (ICF-RS) for evaluation of rehabilitation outcomes of patients with femoral fracture.MethodsA 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 function and overall dysfunction before surgery (at admission), after surgery (the second day after operation) and after recovery (at discharge), 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.ResultsThe ICF-RS evaluation 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 (exercise 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 artificial 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.ConclusionThe 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.
