Determinants of functional outcome in hip fracture: the role of comorbidity

Gialanella, Bernardo; Prometti, Paola; Monguzzi, Vittoria; Ferlucci, Cristina; Baiardi, Paola; Comini, Laura

doi:10.1007/s40520-017-0812-x

Cited by 22 publications

(17 citation statements)

References 23 publications

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“…Another important reason behind the finding of an acceptable level of function and mobility at one year in our patients was the pre-fracture ability to walk independently of more than 75% of the patients. Basic activities of the patients were reported as an important determinant of outcome in hip fracture [25]. Our results on improvement in activities of daily living and walking ability at 1 year compared to 3 months after operation are similar to those from a study by Valaviciene et al [23].…”

Section: Discussionsupporting

confidence: 90%

Does Mobility of the Elderly with Hip Fractures Improve at One Year Following Surgery? A 5-year Prospective Survey

Pourabbas

Emami

Vosoughi

et al. 2016

Ortop Traumatol Rehabil

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Section: Discussionsupporting

confidence: 90%

Does Mobility of the Elderly with Hip Fractures Improve at One Year Following Surgery? A 5-year Prospective Survey

Pourabbas

Emami

Vosoughi

et al. 2016

Ortop Traumatol Rehabil

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“…7 Prior studies in community-dwelling older adults who have sustained hip fracture have included functionally heterogeneous populations 5,[9][10][11][12] and have established that the strongest risk factor for postfracture functional decline is prefracture disability. 5,[9][10][11][12] However, 60% of hip fractures occur in persons without preexisting disability, 13,14 emphasizing the need to understand what factors predict functional decline in this important subgroup. Other risk factors for functional decline are age, 11,15 multimorbidity, 9 cognitive impairment, 9,12,16,17 and in-hospital delirium.…”

mentioning

confidence: 99%

Functional Outcomes After Hip Fracture in Independent Community‐Dwelling Patients

Ouellet

Romegialli

et al. 2019

J American Geriatrics Society

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OBJECTIVES To determine predictors of new activities of daily living (ADLs) disability and worsened mobility disability and secondarily increased daily care hours received, in previously independent hip fracture patients. DESIGN Retrospective cohort study. SETTING Academic hospital with ambulatory follow‐up. PARTICIPANTS Community‐dwelling adults 65 years or older independent in ADLs undergoing hip fracture surgery in 2015 (n = 184). MEASUREMENTS Baseline, 3‐ and 6‐month ADLs, mobility, and daily care hours received were ascertained by telephone survey and chart review. Comorbidities, medications, and characteristics of hospitalization were extracted from patient charts. Models for each outcome used logistic regression with a backward elimination strategy, adjusting a priori for age, sex, and race. RESULTS Predictors of new ADL disability at 3 months were dementia (odds ratio [OR] = 11.81; P = .001) and in‐hospital delirium (OR = 4.20; P = .002), and at 6 months were age (OR = 1.04; P = .014), dementia (OR = 9.91; P = .001), in‐hospital delirium (OR = 3.00; P = .031) and preadmission opiates (OR = 7.72; P = .003). Predictors of worsened mobility at 3 months were in‐hospital delirium (OR = 4.48; P = .001) and number of medications (OR = 1.13; P = .003), and at 6 months were age (OR = 1.06; P = .001), preadmission opiates (OR = 7.23; P = .005), in‐hospital delirium (OR = 3.10; P = .019), and number of medications (OR = 1.13; P = .013). Predictors of increased daily care hours received at 3 and 6 months were age (3 months: OR = 1.07; P = .014; 6 months: OR = 1.06; P = .017) and number of medications (3 months: OR = 1.13; P = .004; 6 months: OR = 1.22; P = .013). The proportion of patients with ADL disability and care hours received did not change from 3 to 6 months, yet there were significant improvements in mobility. CONCLUSION Age, dementia, in‐hospital delirium, number of medications, and preadmission opiate use were predictors of poor outcomes in independent older adults following hip fracture. Further investigation is needed to identify factors associated with improved mobility measures from 3 to 6 months to ultimately optimize recovery.

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“…While some outcome measures are described, such as those by Atkins et al [24] and Foy et al [10], the majority of results were described in terms of degrees of flexion and/or extension gained or lost, arc of motion and its location, range of motion, or general ADL task completion. Vascellari et al assessed functional versus patientreported outcomes following total knee arthroplasty and found a non-significant, very weak correlation between range of motion and ADL sub-scores [25]; Gialanella et al investigated determinants of outcome in hip fractures and showed that basic ADLs had a strong relationship with functional outcomes [26]. Together, these two studies demonstrate that functional outcomes are better assessed using ADL task completion as compared to range of motion.…”

Section: Discussionmentioning

confidence: 99%

Outcomes at 2-Year Minimum Follow Up of Shoulder, Elbow and Wrist Surgery in Individuals with Arthrogryposis Multiplex Congenita

Miller¹,

Sawatzky²

2017

J Clin Exp Orthop

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Background: Arthrogryposis Multiplex Congenita (AMC) is a rare condition that has not been extensively studied, and the need for further research has been strongly emphasized. Despite substantial functional impact resulting from AMC, minimal research has been completed regarding mid-to long-term outcomes in this population. The objective of this systematic review was to identify existing knowledge concerning outcomes of shoulder, elbow and wrist surgery with a minimum two year follow-up in individuals with AMC.

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Determinants of functional outcome in hip fracture: the role of comorbidity

Cited by 22 publications

References 23 publications

Does Mobility of the Elderly with Hip Fractures Improve at One Year Following Surgery? A 5-year Prospective Survey

Does Mobility of the Elderly with Hip Fractures Improve at One Year Following Surgery? A 5-year Prospective Survey

Functional Outcomes After Hip Fracture in Independent Community‐Dwelling Patients

Outcomes at 2-Year Minimum Follow Up of Shoulder, Elbow and Wrist Surgery in Individuals with Arthrogryposis Multiplex Congenita

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