OBJECTIVE: To evaluate baseline characteristics and in-hospital factors associated with nonadherence with an immediate weight-bearing and early ambulation (IWB-EA) program after hip fracture (HF) surgery. DESIGN: Prospective inception cohort study. SETTING: Ortho-geriatric unit in an acute care hospital. PARTICIPANTS: Older adults (N=469) admitted with an osteoporotic HF who underwent surgery. INTERVENTIONS: Immediate weight-bearing and assisted ambulation training on the first postoperative day (all patients). MAIN OUTCOME MEASURE: Proportion of subjects who adhered to the IWB-EA protocol within 48 hours of surgery. RESULTS: A total of 366 patients (78%) bore weight and ambulated within 48 hours (weight-bearing [WB] group) while the others did not adhere to the protocol (nonweight-bearing [NWB] group). Subjects in the NWB group were significantly older, were more cognitively and functionally impaired, and presented a higher comorbidity at baseline. A higher proportion of subjects in the NWB group (42.7%) than the WB group (23.5%; P<.001) underwent surgery on a preholiday day. In multivariate analysis, having surgery on Friday or a preholiday day (the day before a public holiday) remained the most influent variable related to nonadherence to the IWB-EA protocol (odds ratio=2.5; 95% confidence interval=1.6-4.0; P<.001). CONCLUSIONS: This study establishes that IWB-EA is feasible in a high proportion of patients after surgical stabilization of HF. Neither cognitive impairment nor high comorbidity influenced significantly the adherence to the protocol, indicating that IWB-EA may be offered to an unselected population of the elderly with HF. The day of surgery (eg, preholiday or not) was the only variable influencing the participation to the IWB-EA protocol, suggesting the importance of maintaining the same standard of daytime care every day of the week.
OBJECTIVE: To evaluate baseline characteristics and in-hospital factors associated with nonadherence with an immediate weight-bearing and early ambulation (IWB-EA) program after hip fracture (HF) surgery. DESIGN: Prospective inception cohort study. SETTING: Ortho-geriatric unit in an acute care hospital. PARTICIPANTS: Older adults (N=469) admitted with an osteoporotic HF who underwent surgery. INTERVENTIONS: Immediate weight-bearing and assisted ambulation training on the first postoperative day (all patients). MAIN OUTCOME MEASURE: Proportion of subjects who adhered to the IWB-EA protocol within 48 hours of surgery. RESULTS: A total of 366 patients (78%) bore weight and ambulated within 48 hours (weight-bearing [WB] group) while the others did not adhere to the protocol (nonweight-bearing [NWB] group). Subjects in the NWB group were significantly older, were more cognitively and functionally impaired, and presented a higher comorbidity at baseline. A higher proportion of subjects in the NWB group (42.7%) than the WB group (23.5%; P<.001) underwent surgery on a preholiday day. In multivariate analysis, having surgery on Friday or a preholiday day (the day before a public holiday) remained the most influent variable related to nonadherence to the IWB-EA protocol (odds ratio=2.5; 95% confidence interval=1.6-4.0; P<.001). CONCLUSIONS: This study establishes that IWB-EA is feasible in a high proportion of patients after surgical stabilization of HF. Neither cognitive impairment nor high comorbidity influenced significantly the adherence to the protocol, indicating that IWB-EA may be offered to an unselected population of the elderly with HF. The day of surgery (eg, preholiday or not) was the only variable influencing the participation to the IWB-EA protocol, suggesting the importance of maintaining the same standard of daytime care every day of the week.
Authors: Anaar Siletz; Christopher P Childers; Claire Faltermeier; Emily S Singer; Q Lina Hu; Clifford Y Ko; Stephen L Kates; Melinda Maggard-Gibbons; Elizabeth Wick Journal: Geriatr Orthop Surg Rehabil Date: 2018-05-20
Authors: Jordan C Villa; Joseph Koressel; Jelle P van der List; Matthew Cohn; David S Wellman; Dean G Lorich; Joseph M Lane Journal: Geriatr Orthop Surg Rehabil Date: 2019-01-10
Authors: Azeem Tariq Malik; Catherine Quatman-Yates; Laura S Phieffer; Thuan V Ly; Safdar N Khan; Carmen E Quatman Journal: Geriatr Orthop Surg Rehabil Date: 2019-04-30