Mattia Morri1, Paolo Chiari2, Cristiana Forni3, Antonella Orlandi Magli4, Domenica Gazineo2, Natalia Franchini4, Lorenzo Marconato5, Tiziana Giamboi4, Andrea Cotti4. 1. Department of Nursing and Allied Health Professions, Rizzoli Orthopaedic Institute, Bologna, Italy. Electronic address: mattia.morri@ior.it. 2. Department of Medicine and Surgical Sciences, University of Bologna, Italy. 3. Research Nursing Unit, Rizzoli Orthopaedic Institute, Bologna, Italy. 4. Department of Nursing and Allied Health Professions, Rizzoli Orthopaedic Institute, Bologna, Italy. 5. Department of Physical Therapy and Rehabilitation, Bologna University Hospital Authority St. Orsola-Malpighi Polyclinic, Bologna, Italy.
Abstract
OBJECTIVE: To identify the factors associated with recovering autonomy in activities of daily living (ADL) in patients who have had a hip fracture. DESIGN: A prospective cohort study. SETTING: The orthopedic and orthogeriatric departments of 2 regional hospitals. PARTICIPANTS: Patients (N=742) aged ≥65 years with a diagnosis of fragility hip fracture. MAIN OUTCOME MEASURES: The level of autonomy at 4 months was assessed using the ADL scale. RESULTS: The median score on the ADL scale at 4 months was 3 (interquartile range, 5). Half of the population was unable to recover their prefracture autonomy levels. The following were found to be risk factors: increasing age (B=.02, P<.001); an elevated number of comorbidities (B=.044, P=.005); a lower level of prefracture autonomy (B=.087, P<.001); more frequent use of an antidecubitus mattress (B=.211, P<.001); an increased number of days with disorientation (B=.002, P=.012); failure to recover deambulation (B=.199, P<.001); an increased number of days with diapers (B=.003, P<.001), with a urinary catheter (B=.03, P<.001), and with bed rails (B=.001, P=.014); and a nonintensive care pathway (B=.199, P=.014). CONCLUSIONS: Recovery of deambulation, treatment of disorientation and management of incontinence are modifiable factors significantly associated with the functional recovery of autonomy.
OBJECTIVE: To identify the factors associated with recovering autonomy in activities of daily living (ADL) in patients who have had a hip fracture. DESIGN: A prospective cohort study. SETTING: The orthopedic and orthogeriatric departments of 2 regional hospitals. PARTICIPANTS: Patients (N=742) aged ≥65 years with a diagnosis of fragility hip fracture. MAIN OUTCOME MEASURES: The level of autonomy at 4 months was assessed using the ADL scale. RESULTS: The median score on the ADL scale at 4 months was 3 (interquartile range, 5). Half of the population was unable to recover their prefracture autonomy levels. The following were found to be risk factors: increasing age (B=.02, P<.001); an elevated number of comorbidities (B=.044, P=.005); a lower level of prefracture autonomy (B=.087, P<.001); more frequent use of an antidecubitus mattress (B=.211, P<.001); an increased number of days with disorientation (B=.002, P=.012); failure to recover deambulation (B=.199, P<.001); an increased number of days with diapers (B=.003, P<.001), with a urinary catheter (B=.03, P<.001), and with bed rails (B=.001, P=.014); and a nonintensive care pathway (B=.199, P=.014). CONCLUSIONS: Recovery of deambulation, treatment of disorientation and management of incontinence are modifiable factors significantly associated with the functional recovery of autonomy.
Authors: Francisco José Tarazona-Santabalbina; Cristina Ojeda-Thies; Jesús Figueroa Rodríguez; Concepción Cassinello-Ogea; José Ramón Caeiro Journal: Int J Environ Res Public Health Date: 2021-03-16 Impact factor: 3.390