Outcomes of elderly hip fracture patients in the Swiss healthcare system

Pretto, Manuela; Spirig, Rebecca; Kaelin, Raphael; Muri-John, Vanessa; Kressig, Reto W.; Suhm, Norbert

doi:10.4414/smw.2010.13086

Cited by 19 publications

(12 citation statements)

References 21 publications

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“…Hip fracture is one of the most common and serious health care problems among elderly people. Indeed, hip fractures are a major cause of mortality and disability, given that the risk of dying within the first year after this injury has been reported to be as high as 13-36% (Johansen, Mansor, Beck, Mahoney, & Thomas, 2010; Pretto et al, 2010). …”

Section: Hip Fracture Among Elderly Peoplementioning

confidence: 99%

The role of autobiographical story-telling during rehabilitation among hip-fracture geriatric patients

et al. 2018

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Hip fracture is one of the most common health care problems among elderly people. Literature shows that high self-efficacy expectations and positive affect are some of the key issues in functional recovery after hip fracture. The present investigation tested whether self-narration of such life-breaking event influences self-efficacy and depression during the process of rehabilitation. We designed a Self-Narration Journey (SNJ) to be administered during the in-hospital rehabilitation. In Study 1, we investigated the influence of SNJ on depression and perceived self-efficacy. Study 2 aimed to explore the effect of SNJ, depression, and self-efficacy on functional recovery of independence to perform daily activities during the rehabilitation process. The data showed that the Self-Narration Journey proved effective in increasing the perceived self-efficacy and in lowering the level of depression. The present work highlights a significant effect of the SNJ on the functional recovery process.

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Section: Hip Fracture Among Elderly Peoplementioning

confidence: 99%

The role of autobiographical story-telling during rehabilitation among hip-fracture geriatric patients

et al. 2018

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“…Hip fractures often affect functionality and autonomy of older adults [14], and are associated with an overall mortality of 22% to 29% one year after injury [15]. In this context, 27% of older adults require a walking aid one year after a hip fracture surgery [16]. Despite rehabilitation, many individuals do not regain the level of functional performance they had before the fracture [14] which is why fall prevention is important.…”

Section: Introductionmentioning

confidence: 99%

A best practice fall prevention exercise program to improve balance, strength / power, and psychosocial health in older adults: study protocol for a randomized controlled trial

et al. 2013

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BackgroundWith increasing age neuromuscular deficits (e.g., sarcopenia) may result in impaired physical performance and an increased risk for falls. Prominent intrinsic fall-risk factors are age-related decreases in balance and strength / power performance as well as cognitive decline. Additional studies are needed to develop specifically tailored exercise programs for older adults that can easily be implemented into clinical practice. Thus, the objective of the present trial is to assess the effects of a fall prevention program that was developed by an interdisciplinary expert panel on measures of balance, strength / power, body composition, cognition, psychosocial well-being, and falls self-efficacy in healthy older adults. Additionally, the time-related effects of detraining are tested.Methods/DesignHealthy old people (n = 54) between the age of 65 to 80 years will participate in this trial. The testing protocol comprises tests for the assessment of static / dynamic steady-state balance (i.e., Sharpened Romberg Test, instrumented gait analysis), proactive balance (i.e., Functional Reach Test; Timed Up and Go Test), reactive balance (i.e., perturbation test during bipedal stance; Push and Release Test), strength (i.e., hand grip strength test; Chair Stand Test), and power (i.e., Stair Climb Power Test; countermovement jump). Further, body composition will be analysed using a bioelectrical impedance analysis system. In addition, questionnaires for the assessment of psychosocial (i.e., World Health Organisation Quality of Life Assessment-Bref), cognitive (i.e., Mini Mental State Examination), and fall risk determinants (i.e., Fall Efficacy Scale – International) will be included in the study protocol. Participants will be randomized into two intervention groups or the control / waiting group. After baseline measures, participants in the intervention groups will conduct a 12-week balance and strength / power exercise intervention 3 times per week, with each training session lasting 30 min. (actual training time). One intervention group will complete an extensive supervised training program, while the other intervention group will complete a short version ('3 times 3’) that is home-based and controlled by weekly phone calls. Post-tests will be conducted right after the intervention period. Additionally, detraining effects will be measured 12 weeks after program cessation. The control group / waiting group will not participate in any specific intervention during the experimental period, but will receive the extensive supervised program after the experimental period.DiscussionIt is expected that particularly the supervised combination of balance and strength / power training will improve performance in variables of balance, strength / power, body composition, cognitive function, psychosocial well-being, and falls self-efficacy of older adults. In addition, information regarding fall risk assessment, dose–response-relations, detraining effects, and supervision of training will be provided. Further, training-induced he...

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“… 1 2 Older adults who sustain orthopaedic trauma may experience difficulty returning to premorbid functional status and participating in activities of daily living. 3 The risk of disability, postsurgical complications and subsequent fractures increases with older age. 4 Older adults who have been hospitalised with a fragility fracture may require additional supports or admission to a residential aged care facility.…”

Section: Introductionmentioning

confidence: 99%

“… 4 Older adults who have been hospitalised with a fragility fracture may require additional supports or admission to a residential aged care facility. 3 …”

Section: Introductionmentioning

confidence: 99%

Gait outcomes of older adults receiving subacute hospital rehabilitation following orthopaedic trauma: a longitudinal cohort study

et al. 2017

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ObjectivesThis study aimed to describe gait speed at admission and discharge from inpatient hospital rehabilitation among older adults recovering from orthopaedic trauma and factors associated with gait speed performance and discharge destination.DesignA longitudinal cohort study was conducted.SettingAustralian tertiary hospital subacute rehabilitation wards.ParticipantsPatients aged ≥60 years recovering from orthopaedic trauma (n=746, 71% female) were eligible for inclusion.InterventionsUsual care (multidisciplinary inpatient hospital rehabilitation).Primary and secondary outcome measuresGait speed was assessed using the timed 10 m walk test. The proportion of patients exceeding a minimum gait speed threshold indicator (a priori 0.8 m/s) of community ambulation ability was calculated. Generalised linear models were used to examine associations between patient and clinical factors with gait speed performance and being discharged to a residential aged care facility.ResultsAt discharge, 18% of patients (n=135) exceeded the 0.8 m/s threshold indicator for community ambulation ability. Faster gait speed at discharge was found to be associated with being male (B=0.43, 95% CI −0.01 to 0.87), admitted with pelvic (B=0.76, 95% CI 0.14 to 1.37) or multiple fractures (B=1.13, 95% CI 0.25 to 2.01) (vs hip fracture), using no mobility aids (B=−0.93, 95% CI −1.89 to 0.01) and walking at a faster gait speed at admission (B=5.77, 95% CI 5.03 to 6.50). Factors associated with being discharged to residential aged care included older age (OR 1.06, 95% CI 1.03 to 1.10), longer length of stay (OR 1.01, 95% CI 1.01 to 1.02), having an upper limb fracture (vs hip fracture) (OR 2.81, 95% CI 1.32 to 5.97) and lower Functional Independence Measure cognitive score (OR 0.89, 95% CI 0.86 to 0.92).ConclusionsPatients with a range of injury types, not only those presenting to hospital with hip fractures, are being discharged with slow gait speeds that are indicative of limited functional mobility and a high risk of further adverse health events.

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Outcomes of elderly hip fracture patients in the Swiss healthcare system

Abstract: Our results reflect the clinical reality of the hip fracture population in Switzerland. Results one year after fracture were comparable to study findings in different health care systems. Our findings provide important baseline data prior to the implementation of DRG and GFC.

Cited by 19 publications

References 21 publications

The role of autobiographical story-telling during rehabilitation among hip-fracture geriatric patients

The role of autobiographical story-telling during rehabilitation among hip-fracture geriatric patients

A best practice fall prevention exercise program to improve balance, strength / power, and psychosocial health in older adults: study protocol for a randomized controlled trial

Gait outcomes of older adults receiving subacute hospital rehabilitation following orthopaedic trauma: a longitudinal cohort study

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