Factors Predicting Mobility and the Change in Activities of Daily Living After Hip Fracture

Abstract

Prognostic Level I. See Instructions for Authors for a complete description of levels of evidence.

Less than one‐third of hip fracture patients return to their prefracture level of instrumental activities of daily living in a prospective cohort study of 480 patients

“…Two other studies (Mariconda et al and Gonzalez Zabaleta et al ) investigated predictors for IADL after a hip fracture. Older age, higher ASA classification and lower prefracture IADL were found to be predictors in these studies, which is in accordance with the present results . Furthermore, Mariconda et al found that prefracture ambulatory ability and postoperative complications were associated with IADL, as we did.…”

“…Age, ASA classification, prefracture living situation and use of walking aids were predictors for baseline IADL. Sex, prefracture living with a partner and type of fracture were not predictors for lower baseline IADL in the present multivariate analysis, in accordance with other cohort studies . Two previous studies showed that an extracapsular fracture is more common in older patients with more comorbidities and lower functional recovery .…”

“…Furthermore, Mariconda et al found that prefracture ambulatory ability and postoperative complications were associated with IADL, as we did. In addition to these predictors, they found the Mini‐Mental State Examination score, postoperative allowance of full weight‐bearing on the operated limb, surgery within 72 h, Parkinson's disease and educational status to be associated . These factors were not included in the present study.…”

Secondary Fracture Prevention: Consensus Clinical Recommendations from a Multistakeholder Coalition

“…Approximately half of hip fracture patients who survive to 1 year do not regain their prior functionality (25) nor does their health status return to prefracture levels. (30) Of patients surviving 1 year who needed no walking aids prior, approximately 40% require assistance. (30) Of patients surviving 1 year who needed no walking aids prior, approximately 40% require assistance.…”

“…(26) Only about one-third to one-half of hip fracture survivors regain prior ambulatory function, (27)(28)(29) and around 13% may be unable to ambulate at all. (30) Loss of autonomy and independence is also reflected in changes of residential settings after fracture. (30) Loss of autonomy and independence is also reflected in changes of residential settings after fracture.…”