Bernardo Gialanella1, Raffaele Santoro2, Paola Prometti2, Alessandro Giordano2, Vittoria Monguzzi3, Laura Comini4, Adriana Olivares4, Giuseppe Grioni5. 1. Operative Unit for Recovery and Functional Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Via G. Mazzini, 129, Lumezzane, 25065, Brescia, Italy. gialanellab@gmail.com. 2. Operative Unit for Recovery and Functional Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Via G. Mazzini, 129, Lumezzane, 25065, Brescia, Italy. 3. Operative Unit for Recovery and Functional Rehabilitation of the Institute of Lissone, Istituti Clinici Scientifici Maugeri IRCCS, Monza-Brianza, Italy. 4. Istituti Clinici Scientifici Maugeri IRCCS, Scientific Direction of the Institute of Lumezzane, Brescia, Italy. 5. Operative Unit for Recovery and Functional Rehabilitation of the Institute of Castel Goffredo, Istituti Clinici Scientifici Maugeri IRCCS, Mantova, Italy.
Abstract
BACKGROUND AND AIM: The aim of this prospective observational cohort study was to verify the relationship between number of drugs used and functional outcome in hip fracture patients undergoing rehabilitation. METHODS: This study was conducted on 139 patients with hip fracture who underwent a rehabilitation program. Efficiency rate in the Functional Independence Measure (FIM) and Berg Balance Scale (BBS), and length of stay (LOS) were the outcome measures. RESULTS: At the end of rehabilitation, 66.1% of patients showed an increase in number of drugs used, while 33.9% used the same or lower number of drugs than at admission. At the end of rehabilitation patients with increased pharmacotherapy took a higher total number of drug classes (p = 0.001), had longer LOS (p = 0.009) and lower Berg efficiency (p = 0.048) than patients with the same or lower pharmacotherapy. The number of drugs used at discharge was an independent determinant of LOS (beta = 0.19, p = 0.022) and FIM efficiency (beta = - 0.20, p = 0.025). Age was a determinant of LOS (beta = 0.17, p = 0.044) and BBS efficiency (beta = - 0.23, p = 0.009), while CIRS severity was a determinant of BBS efficiency only (beta = - 0.22, p = 0.016). DISCUSSION: Findings of study indicate that in hip fracture patients, the number of drugs prescribed at discharge is an important indicator of LOS and rehabilitation efficiency. CONCLUSIONS: These findings can help the physician to better plan the rehabilitation of hip fracture patients who require polypharmacy.
BACKGROUND AND AIM: The aim of this prospective observational cohort study was to verify the relationship between number of drugs used and functional outcome in hip fracturepatients undergoing rehabilitation. METHODS: This study was conducted on 139 patients with hip fracture who underwent a rehabilitation program. Efficiency rate in the Functional Independence Measure (FIM) and Berg Balance Scale (BBS), and length of stay (LOS) were the outcome measures. RESULTS: At the end of rehabilitation, 66.1% of patients showed an increase in number of drugs used, while 33.9% used the same or lower number of drugs than at admission. At the end of rehabilitation patients with increased pharmacotherapy took a higher total number of drug classes (p = 0.001), had longer LOS (p = 0.009) and lower Berg efficiency (p = 0.048) than patients with the same or lower pharmacotherapy. The number of drugs used at discharge was an independent determinant of LOS (beta = 0.19, p = 0.022) and FIM efficiency (beta = - 0.20, p = 0.025). Age was a determinant of LOS (beta = 0.17, p = 0.044) and BBS efficiency (beta = - 0.23, p = 0.009), while CIRS severity was a determinant of BBS efficiency only (beta = - 0.22, p = 0.016). DISCUSSION: Findings of study indicate that in hip fracturepatients, the number of drugs prescribed at discharge is an important indicator of LOS and rehabilitation efficiency. CONCLUSIONS: These findings can help the physician to better plan the rehabilitation of hip fracturepatients who require polypharmacy.
Entities:
Keywords:
Drugs; Hip fracture; Outcome; Rehabilitation