G Pioli1, F Lauretani2, F Pellicciotti3, P Pignedoli4, C Bendini3, M L Davoli3, E Martini5, A Zagatti6, A Giordano2, A Nardelli2, A Zurlo6, D Bianchini7, E Sabetta4, A Ferrari3, C Tedeschi7, M L Lunardelli5. 1. Geriatric Unit, Department of Neuromotor Physiology, ASMN-IRCCS, Via Risorgimento 70, 42100, Reggio Emilia, Italy. giulio.pioli@asmn.re.it. 2. Geriatric Unit, Geriatric-Rehabilitation Department, University Hospital of Parma, Parma, Italy. 3. Geriatric Unit, Department of Neuromotor Physiology, ASMN-IRCCS, Via Risorgimento 70, 42100, Reggio Emilia, Italy. 4. Orthopaedic Unit, Department of Neuromotor Physiology, ASMN-IRCCS, Reggio Emilia, Italy. 5. Orthogeriatric Unit, Department of Internal Medicine, Aging and Nephrology, University Hospital Policlinico S.Orsola Malpighi, Bologna, Italy. 6. Orthogeriatric Unit, S. Anna Hospital, Ferrara, Italy. 7. Physical and Rehabilitation Medicine Unit, Department of Neuromotor Physiology, ASMN-IRCCS, Reggio Emilia, Italy.
Abstract
UNLABELLED: Modifiable and non-modifiable predictors of mobility recovery were analyzed on a sample of 774 hip fracture patients according to pre-fracture abilities. Overall predictors were mostly non-modifiable factors related to frailty of patients with the exception of 25-hydroxyvitamin D concentration which significantly affected walking recovery, especially in patients with higher pre-fracture performance. INTRODUCTION: This study aims to investigate mobility changes after hip fracture with the aim of identifying modifiable and non-modifiable predictors of mobility recovery according to different pre-fracture abilities. METHODS: This is a prospective inception cohort study of consecutive older patients, admitted with a fragility hip fracture in three Hospitals of Emilia Romagna (Italy). A sample of 774 patients alive at the sixth month was divided into three groups according to pre-fracture ambulation ability (group 1: mobile outdoors; group 2: mobile indoors; and group 3: mobile with help). The relationship between baseline characteristics of patients and the odds of walking recovery was analyzed using multivariate regression analysis. RESULTS: Mortality differed significantly among the three groups and was the highest in patients needing help to walk. Among the survivors, only 50.3 % of patients recovered walking ability. In a multivariate analysis, independent risk factors were different among the three groups. In group 1, older age, comorbidities, the use of walking devices before fracture, and low albumin level acted as negative factors while male gender, a pre-fracture high functional status, and higher 25-hydroxyvitamin D levels increased the probability of full recovery. In group 2, only pre-fracture functional status and 25-hydroxyvitamin D concentration were related to the recovery of walking ability. Pre-fracture functional status was also the only significant predictor for patients in group 3. CONCLUSIONS: Several baseline characteristics of patients are related to the likelihood of recovering walking ability after hip fracture. The 25-hydroxyvitamin D level seems to be the only relevant modifiable factor even if the effectiveness of its supplementation has yet to be demonstrated.
UNLABELLED: Modifiable and non-modifiable predictors of mobility recovery were analyzed on a sample of 774 hip fracturepatients according to pre-fracture abilities. Overall predictors were mostly non-modifiable factors related to frailty of patients with the exception of 25-hydroxyvitamin D concentration which significantly affected walking recovery, especially in patients with higher pre-fracture performance. INTRODUCTION: This study aims to investigate mobility changes after hip fracture with the aim of identifying modifiable and non-modifiable predictors of mobility recovery according to different pre-fracture abilities. METHODS: This is a prospective inception cohort study of consecutive older patients, admitted with a fragility hip fracture in three Hospitals of Emilia Romagna (Italy). A sample of 774 patients alive at the sixth month was divided into three groups according to pre-fracture ambulation ability (group 1: mobile outdoors; group 2: mobile indoors; and group 3: mobile with help). The relationship between baseline characteristics of patients and the odds of walking recovery was analyzed using multivariate regression analysis. RESULTS: Mortality differed significantly among the three groups and was the highest in patients needing help to walk. Among the survivors, only 50.3 % of patients recovered walking ability. In a multivariate analysis, independent risk factors were different among the three groups. In group 1, older age, comorbidities, the use of walking devices before fracture, and low albumin level acted as negative factors while male gender, a pre-fracture high functional status, and higher 25-hydroxyvitamin D levels increased the probability of full recovery. In group 2, only pre-fracture functional status and 25-hydroxyvitamin D concentration were related to the recovery of walking ability. Pre-fracture functional status was also the only significant predictor for patients in group 3. CONCLUSIONS: Several baseline characteristics of patients are related to the likelihood of recovering walking ability after hip fracture. The 25-hydroxyvitamin D level seems to be the only relevant modifiable factor even if the effectiveness of its supplementation has yet to be demonstrated.
Authors: Heike A Bischoff-Ferrari; Thomas Dietrich; E John Orav; Frank B Hu; Yuqing Zhang; Elisabeth W Karlson; Bess Dawson-Hughes Journal: Am J Clin Nutr Date: 2004-09 Impact factor: 7.045
Authors: J Magaziner; W Hawkes; J R Hebel; S I Zimmerman; K M Fox; M Dolan; G Felsenthal; J Kenzora Journal: J Gerontol A Biol Sci Med Sci Date: 2000-09 Impact factor: 6.053
Authors: Joep B Ponten; Egbert Krug; Laurens J van Baardewijk; Enrike H M J van der Linden; Renée Haas; Pieta Krijnen; Inger B Schipper Journal: J Rehabil Med Date: 2015-03 Impact factor: 2.912
Authors: Giulio Pioli; Fulvio Lauretani; Maria Luisa Davoli; Emilio Martini; Carlo Frondini; Francesca Pellicciotti; Anna Zagatti; Antonio Giordano; Ilaria Pedriali; Anna Nardelli; Amedeo Zurlo; Alberto Ferrari; Maria Lia Lunardelli Journal: J Gerontol A Biol Sci Med Sci Date: 2012-03-27 Impact factor: 6.053
Authors: Dallas P Seitz; Sudeep S Gill; Andrea Gruneir; Peter C Austin; Geoffrey M Anderson; Chaim M Bell; Paula A Rochon Journal: J Am Med Dir Assoc Date: 2014-02-11 Impact factor: 4.669
Authors: Giuseppe Bellelli; Paolo Mazzola; Alessandro Morandi; Adriana Bruni; Lucio Carnevali; Maurizio Corsi; Giovanni Zatti; Antonella Zambon; Giovanni Corrao; Birgitta Olofsson; Yngve Gustafson; Giorgio Annoni Journal: J Am Geriatr Soc Date: 2014-06-02 Impact factor: 5.562
Authors: Amer N Al-Ani; Lena Flodin; Anita Söderqvist; Paul Ackermann; Eva Samnegård; Nils Dalén; Maria Sääf; Tommy Cederholm; Margareta Hedström Journal: Arch Phys Med Rehabil Date: 2010-01 Impact factor: 3.966
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