Does Functional Recovery in Elderly Hip Fracture Patients Differ Between Patients Admitted From Long-Term Care and the Community?

Beaupré, Lauren A; Cinats, John G.; Jones, Chelsea; Scharfenberger, Angela; Johnston, D. W. C.; Senthilselvan, A; Saunders, L. Duncan

doi:10.1093/gerona/62.10.1127

Cited by 91 publications

(99 citation statements)

References 35 publications

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“…At 6 months post-fracture, a greater proportion of those living in the community before the fracture recovered their pre-fracture function, in comparison to those living in long term care (Table 4 p < 0.001) [48]. The adjusted reduction in pre-fracture function at 6 months was 33 % (95 % CI −40.6 to −27.2) for those in long-term care, and 12 % (95 % CI −14.8 to −8.4) for those community dwelling before the fracture [48]. It should be noted that the pre-fracture mobility of the people in all of these studies was determined retrospectively, so there is a risk of bias in these data.…”

Section: Composite Measures Of Basic Activities Of Daily Livingmentioning

confidence: 99%

Section: Activity Outcomes Mobilitymentioning

confidence: 99%

“…Four articles on three cohorts reported functional outcomes for people in residential care [28,[48][49][50]. Canadian and Australian studies have found that recovery of mobility is lower for those living in residential care than for those living in the community (Table 4; Additional file 1: Table S3) [48,49]. A large retrospective study of people living in nursing homes in the US reported that, of those who were independently mobile pre-fracture, only 21 % survive and regain their pre-fracture independence at a median Table 4 for other studies, as the rate indicates a composite of recovery and survival, rather than representing the rate of recovery as a proportion of those surviving.…”

Section: Activity Outcomes Mobilitymentioning

confidence: 99%

“…Outcomes for people living in residential care prefracture Two studies from Canada and Australia indicate that those living in long-term care before a fracture have a poorer recovery than those living in the community (Table 4, Additional file 1: Table S3) [48,49]. At 6 months post-fracture, a greater proportion of those living in the community before the fracture recovered their pre-fracture function, in comparison to those living in long term care (Table 4 p < 0.001) [48].…”

Section: Composite Measures Of Basic Activities Of Daily Livingmentioning

confidence: 99%

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A Critical Review of the Long-Term Disability Outcomes Following Hip Fracture

Dyer

Crotty

Fairhall

et al. 2017

Innovation in Aging

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Background: Hip fractures are an increasingly common consequence of falls in older people that are associated with a high risk of death and reduced function. This review aims to quantify the impact of hip fracture on older people's abilities and quality of life over the long term. Methods: Studies were identified through PubMed and Scopus searches and contact with experts. Cohort studies of hip fracture patients reporting outcomes 3 months post-fracture or longer were included for review. Outcomes of mobility, participation in domestic and community activities, health, accommodation or quality of life were categorised according to the World Health Organization's International Classification of Functioning and synthesised narratively. Risk of bias was assessed according to four items from the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Results: Thirty-eight studies from 42 publications were included for review. Most followed a clearly defined sample from the time of fracture. Hip fracture survivors experienced significantly worse mobility, independence in function, health, quality of life and higher rates of institutionalisation than age matched controls. The bulk of recovery of walking ability and activities for daily living occurred within 6 months after fracture. Between 40 and 60 % of study participants recovered their pre-fracture level of mobility and ability to perform instrumental activities of daily living, while 40-70 % regained their level of independence for basic activities of daily living. For people independent in self-care pre-fracture, 20-60 % required assistance for various tasks 1 and 2 years after fracture. Fewer people living in residential care recovered their level of function than those living in the community. In Western nations, 10-20 % of hip fracture patients are institutionalised following fracture. Few studies reported impact on participation in domestic, community, social and civic life.

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Section: Composite Measures Of Basic Activities Of Daily Livingmentioning

confidence: 99%

Section: Activity Outcomes Mobilitymentioning

confidence: 99%

Section: Activity Outcomes Mobilitymentioning

confidence: 99%

Section: Composite Measures Of Basic Activities Of Daily Livingmentioning

confidence: 99%

See 2 more Smart Citations

A Critical Review of the Long-Term Disability Outcomes Following Hip Fracture

Dyer

Crotty

Fairhall

et al. 2017

Innovation in Aging

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“…Individuals living in nursing homes (or other long-term care settings) are at high risk for hip fractures, such that even after adjustment for confounding factors (including cognitive impairment and chronic illness) their risk remains at least twice that of older adults living in the community [2]. Further, individuals living in long-term care (LTC) are less likely to recover function after a hip fracture than community-living individuals [3]. The costs of hip fracture also vary according to the place of residence.…”

Section: Introductionmentioning

confidence: 99%

Osteoporosis management among residents living in long-term care

et al. 2009

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Use of a Case Manager to Improve Osteoporosis Treatment After Hip Fracture

Majumdar¹,

Beaupré²,

Harley³

et al. 2007

Arch Intern Med

132

168

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Background: Patients who survive hip fracture are at high risk of recurrent fractures, but rates of osteoporosis treatment 1 year after sustaining a fracture are less than 10% to 20%. We have developed an osteoporosis case manager intervention. The case manager educated patients, arranged bone mineral density tests, provided prescriptions, and communicated with primary care physicians. The intervention was compared with usual care in a randomized controlled trial. Methods:We recruited from all hospitals that participate in the Capital Health system (Alberta, Canada), including patients 50 years or older who had sustained a hip fracture and excluding those who were receiving osteoporosis treatment or who lived in a long-term care facility. Primary outcome was bisphosphonate therapy 6 months after fracture; secondary outcomes included bone mineral density testing, appropriate care (bone mineral density testing and treatment if bone mass was low), and intervention costs. Results: We screened 2219 patients and allocated 220, as follows: 110 to the intervention group and 110 to the control group. Median age was 74 years, 60% were

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Does Functional Recovery in Elderly Hip Fracture Patients Differ Between Patients Admitted From Long-Term Care and the Community?

Abstract: Following hip fracture, most LTC residents do not regain prefracture function irrespective of known prognostic factors. Further investigation is needed as to the extent to which personal and environmental characteristics contribute to outcome after hip fracture.

Cited by 91 publications

References 35 publications

A Critical Review of the Long-Term Disability Outcomes Following Hip Fracture

A Critical Review of the Long-Term Disability Outcomes Following Hip Fracture

Osteoporosis management among residents living in long-term care

Use of a Case Manager to Improve Osteoporosis Treatment After Hip Fracture

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