Ka Keat Lim1, William Yeo2, Joyce S B Koh3, Chuen Seng Tan4, Hwei Chi Chong2, Karen Zhang2, Truls Østbye1, Tet Sen Howe5, David Bruce Matchar6. 1. Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore. 2. Orthopaedic Diagnostic Centre, Singapore General Hospital, Singapore. 3. Department of Orthopaedic Surgery, Singapore General Hospital, Singapore; Duke-NUS Medical School, Singapore. 4. Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore. 5. Department of Orthopaedic Surgery, Singapore General Hospital, Singapore. 6. Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore; Department of Medicine (General Internal Medicine), Duke University Medical Center, Durham, NC. Electronic address: david.matchar@duke-nus.edu.sg.
Abstract
OBJECTIVES: To examine the associations of 3 measures of prefracture health status (physical function, mental function, and comorbidity count) with trajectories of physical and mental function at 1.5, 3, 6, and 12 months after hip fracture surgery. DESIGN: Single-center observational study. SETTING: Singapore General Hospital (an acute hospital). PARTICIPANTS: Patients aged ≥60 years who underwent first hip fracture surgery between June 2011 and July 2016 (N = 928). INTERVENTION: None. MEASUREMENTS: We used data collected prospectively from the hospital's hip fracture registry. We used the Short Form-36 (SF-36) Physical Component Summary (PCS) and Mental Component Summary (MCS) as indicators of physical and mental function, respectively, collected at admission and at 1.5, 3, 6, and 12 months after hip fracture surgery. Comorbidity count at admission was the sum from a list of 10 common diseases associated with poorer physical function. RESULTS: Prefracture physical function and prefracture mental function demonstrated time-varying associations (interaction P < .001 and P = .001, respectively) with postfracture physical function; the associations were small initially but increased in strength up to 6 months and stabilized thereafter. In contrast, the strength of the association between comorbidity count and postfracture physical function were time-invariant (-0.52, P = .027). The strength of the associations between all 3 measures of prefracture health status and postfracture mental function were also constant over time (0.09, P = .004, for physical function; 0.38, P < .001, for mental function; -0.70, P = .034, for comorbidity count). CONCLUSIONS/IMPLICATIONS: The time-varying associations between prefracture health status and postfracture physical function suggest that even for patients with good prefracture health status, initial recovery may be slow. Our findings can be useful to clinicians and therapists in their prognostic evaluations and in management of patients' expectation for recovery.
OBJECTIVES: To examine the associations of 3 measures of prefracture health status (physical function, mental function, and comorbidity count) with trajectories of physical and mental function at 1.5, 3, 6, and 12 months after hip fracture surgery. DESIGN: Single-center observational study. SETTING: Singapore General Hospital (an acute hospital). PARTICIPANTS: Patients aged ≥60 years who underwent first hip fracture surgery between June 2011 and July 2016 (N = 928). INTERVENTION: None. MEASUREMENTS: We used data collected prospectively from the hospital's hip fracture registry. We used the Short Form-36 (SF-36) Physical Component Summary (PCS) and Mental Component Summary (MCS) as indicators of physical and mental function, respectively, collected at admission and at 1.5, 3, 6, and 12 months after hip fracture surgery. Comorbidity count at admission was the sum from a list of 10 common diseases associated with poorer physical function. RESULTS: Prefracture physical function and prefracture mental function demonstrated time-varying associations (interaction P < .001 and P = .001, respectively) with postfracture physical function; the associations were small initially but increased in strength up to 6 months and stabilized thereafter. In contrast, the strength of the association between comorbidity count and postfracture physical function were time-invariant (-0.52, P = .027). The strength of the associations between all 3 measures of prefracture health status and postfracture mental function were also constant over time (0.09, P = .004, for physical function; 0.38, P < .001, for mental function; -0.70, P = .034, for comorbidity count). CONCLUSIONS/IMPLICATIONS: The time-varying associations between prefracture health status and postfracture physical function suggest that even for patients with good prefracture health status, initial recovery may be slow. Our findings can be useful to clinicians and therapists in their prognostic evaluations and in management of patients' expectation for recovery.
Authors: Willeke M Ravensbergen; Jeanet W Blom; Andrew Kingston; Louise Robinson; Ngaire Kerse; Ruth O Teh; Rolf H H Groenwold; Jacobijn Gussekloo Journal: Age Ageing Date: 2022-01-06 Impact factor: 10.668