The impact of cognitive impairment on short-term outcomes of hip fracture patients.

The purpose of this study is to examine the differences in outcomes related to recovery after hip fracture among patients with and without cognitive impairment. This is a prospective cohort study of consecutively hospitalized elderly patients with acute hip fracture in a setting utilizing a multidisciplinary hip fracture service. Of the 48 patients admitted with hip fracture, 18 patients were found to have cognitive impairment postoperatively as determined by a Mini-Mental State Examination (MMSE) score <or=24. Compared to patients without cognitive impairment, cognitively impaired patients reported no difference in the number of activities of daily living (ADL) performed independently or the number of instrumental activities of daily living (IADL) performed independently in the month prior to admission. There was no difference in hospital length of stay. The impaired group had a mean rehabilitation length of stay that was 8 days longer than that of the unimpaired group. Six weeks after surgery, the number of independent activities did not differ between groups. This investigation suggests that although patients with cognitive impairment require longer rehabilitation courses after hip fracture surgery as compared to those who are cognitively unimpaired, they achieve comparable short-term outcomes in the setting of a dedicated hip fracture service.