Michelle Fitzgerald1, Catherine Blake2, David Askin3, John Quinlan4, Tara Coughlan5, Caitriona Cunningham2. 1. Tallaght Hospital, Physiotherapy Department, Dublin, Ireland. Electronic address: michelle.fitzgerald@amnch.ie. 2. University College Dublin, School of Public Health, Physiotherapy and Sport Science, Dublin, Ireland. 3. Tallaght Hospital, Department of Nursing, Dublin, Ireland. 4. Tallaght Hospital, Department of Trauma and Orthopedics, Dublin, Ireland. 5. Tallaght Hospital, Department of Age-Related Healthcare, Dublin, Ireland.
Abstract
OBJECTIVE: Better patient outcomes and more efficient healthcare could be achieved by predicting post hip fracture function at an early stage. This study aimed to identify independent predictors of mobility outcome one week post hip fracture surgery. METHODS: All hip fracture inpatients (n=77) were included in this 6 month prospective observational cohort study. Predictor variables were obtained on the first postoperative day and included premorbid function using the New Mobility Score (NMS). Mobility outcome measures one week postoperatively included the Cumulated Ambulatory Score (CAS). Data were analysed with SPSS using binary multiple logistic regression analysis RESULTS: Patients who fell outdoors (OR 3.848; 95% CI, 1.053-14.061), had no delay to surgery (OR 5.472; 95% CI, 1.073-27.907) and had high pre-fracture function (OR3.366; 95% CI, 1.042-10.879) were predicted to achieve independent mobility (CAS = 6) one week postoperatively. CONCLUSION: Fall location, time to surgery and baseline function predict independent mobility one week after hip fracture, and can be used for early rehabilitation stratification. The NMS and CAS are recommended as standardised hip fracture clinical measures. Orthogeriatric and physiotherapy service initiatives may improve early functional outcome.
OBJECTIVE: Better patient outcomes and more efficient healthcare could be achieved by predicting post hip fracture function at an early stage. This study aimed to identify independent predictors of mobility outcome one week post hip fracture surgery. METHODS: All hip fracture inpatients (n=77) were included in this 6 month prospective observational cohort study. Predictor variables were obtained on the first postoperative day and included premorbid function using the New Mobility Score (NMS). Mobility outcome measures one week postoperatively included the Cumulated Ambulatory Score (CAS). Data were analysed with SPSS using binary multiple logistic regression analysis RESULTS:Patients who fell outdoors (OR 3.848; 95% CI, 1.053-14.061), had no delay to surgery (OR 5.472; 95% CI, 1.073-27.907) and had high pre-fracture function (OR3.366; 95% CI, 1.042-10.879) were predicted to achieve independent mobility (CAS = 6) one week postoperatively. CONCLUSION: Fall location, time to surgery and baseline function predict independent mobility one week after hip fracture, and can be used for early rehabilitation stratification. The NMS and CAS are recommended as standardised hip fracture clinical measures. Orthogeriatric and physiotherapy service initiatives may improve early functional outcome.
Authors: Rafael Prieto-Moreno; Patrocinio Ariza-Vega; Mariana Ortiz-Piña; Maureen C Ashe; Dulce Romero-Ayuso; Morten Tange Kristensen Journal: Int J Environ Res Public Health Date: 2021-01-15 Impact factor: 3.390
Authors: Richard J VanTienderen; Kyle Bockelman; Rami Khalifa; Michael S Reich; Adam Adler; Mai P Nguyen Journal: Geriatr Orthop Surg Rehabil Date: 2021-03-25