Hanna M Pajulammi1, Harri K Pihlajamäki2, Tiina H Luukkaala3, Maria S Nuotio4. 1. Department of Geriatric Medicine, Seinäjoki Central Hospital, Hanneksenrinne 7, 60220 Seinäjoki, Finland. Electronic address: hanna.pajulammi@fimnet.fi. 2. Division of Orthopedics and Traumatology, Seinäjoki Central Hospital, Hanneksenrinne 7, 60220 Seinäjoki, Finland; University of Tampere, Mediwest, Koskenalantie 16, 60220 Seinäjoki, Finland. 3. Science Center, Pirkanmaa Hospital District, PL 2000, 33521 Tampere, Finland; School of Health Sciences, University of Tampere, 33014 University of Tampere, Finland. 4. Department of Geriatric Medicine, Seinäjoki Central Hospital, Hanneksenrinne 7, 60220 Seinäjoki, Finland.
Abstract
PURPOSE OF THE RESEARCH: Examining pre- and perioperative predictors of changes in mobility and living arrangements after hip fracture. MATERIALS AND METHODS: Population-based prospective data were collected on 1027 hip fracture patients aged ≥65. The outcomes were decreased vs. same or improved mobility level and need for more supported vs. same or less supported living arrangements 1 year after hip fracture. The independent variables were age, gender, body mass index, American Society of Anesthesiologists score, diagnosis of memory disorder, mobility level and living arrangements, fracture type, delay to surgery and urinary catheter removal during acute hospitalization. THE PRINCIPAL RESULTS: Multivariate logistic regression analysis revealed the prefracture mobility level of walking outdoors (OR=0.47, 95% CI 0.30-0.75) or indoors (OR=0.25, 95% CI 0.09-0.72) assisted to be associated with a smaller decrease in mobility level. Non-independent mobility level (OR=2.74, 95% CI 1.70-4.41) was associated with the need of more supported living arrangements. Living in assisted living accommodations (OR=0.23, 95% CI 0.12-0.44) was associated with less need for more supported living arrangements. Removal of the urinary catheter showed a protective association on both decline in mobility level (OR=0.45; 95% CI 0.29-0.70) and moving to a more supported living arrangement(OR=0.49,95% CI 0.31-0.77. MAJOR CONCLUSIONS: Worsening of mobility was significant for independent mobilizers. Prefracture impaired mobility was associated with the need of more supported living arrangements. Living in an assisted living accommodation protected against institutionalization. The findings emphasize the importance of a prompt removal of the urinary catheter after hip fracture.
PURPOSE OF THE RESEARCH: Examining pre- and perioperative predictors of changes in mobility and living arrangements after hip fracture. MATERIALS AND METHODS: Population-based prospective data were collected on 1027 hip fracture patients aged ≥65. The outcomes were decreased vs. same or improved mobility level and need for more supported vs. same or less supported living arrangements 1 year after hip fracture. The independent variables were age, gender, body mass index, American Society of Anesthesiologists score, diagnosis of memory disorder, mobility level and living arrangements, fracture type, delay to surgery and urinary catheter removal during acute hospitalization. THE PRINCIPAL RESULTS: Multivariate logistic regression analysis revealed the prefracture mobility level of walking outdoors (OR=0.47, 95% CI 0.30-0.75) or indoors (OR=0.25, 95% CI 0.09-0.72) assisted to be associated with a smaller decrease in mobility level. Non-independent mobility level (OR=2.74, 95% CI 1.70-4.41) was associated with the need of more supported living arrangements. Living in assisted living accommodations (OR=0.23, 95% CI 0.12-0.44) was associated with less need for more supported living arrangements. Removal of the urinary catheter showed a protective association on both decline in mobility level (OR=0.45; 95% CI 0.29-0.70) and moving to a more supported living arrangement(OR=0.49,95% CI 0.31-0.77. MAJOR CONCLUSIONS: Worsening of mobility was significant for independent mobilizers. Prefracture impaired mobility was associated with the need of more supported living arrangements. Living in an assisted living accommodation protected against institutionalization. The findings emphasize the importance of a prompt removal of the urinary catheter after hip fracture.
Authors: Cristina González de Villaumbrosia; Pilar Sáez López; Isaac Martín de Diego; Carmen Lancho Martín; Marina Cuesta Santa Teresa; Teresa Alarcón; Cristina Ojeda Thies; Rocío Queipo Matas; Juan Ignacio González-Montalvo Journal: Int J Environ Res Public Health Date: 2021-04-06 Impact factor: 3.390
Authors: Markus Laubach; Felix M Bläsius; Ruth Volland; Matthias Knobe; Christian D Weber; Frank Hildebrand; Miguel Pishnamaz Journal: Eur J Trauma Emerg Surg Date: 2021-10-05 Impact factor: 2.374
Authors: Thomas Klestil; Christoph Röder; Christoph Stotter; Birgit Winkler; Stefan Nehrer; Martin Lutz; Irma Klerings; Gernot Wagner; Gerald Gartlehner; Barbara Nussbaumer-Streit Journal: Sci Rep Date: 2018-09-17 Impact factor: 4.379