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Prediction of Postoperative Ambulatory Status 1 Year After Hip Fracture Surgery |
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| Authors: | Jun Hirose Junji Ide Toshitake Yakushiji Yasuyuki Abe Kimiaki Nishida Satoshi Maeda Yoshihisa Anraku Koichiro Usuku Hiroshi Mizuta |
| Institution: | a Department of Medical Information Science and Administration Planning, Kumamoto University, Kumamoto, Japan b Department of Orthopaedic and Neuro-Musculoskeletal Surgery, Kumamoto University, Kumamoto, Japan c Department of Orthopaedic Surgery, Kumamoto Central Hospital, Kumamoto, Japan d Department of Orthopaedic Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan e Department of Orthopaedic Surgery, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan |
| Abstract: | Hirose J, Ide J, Yakushiji T, Abe Y, Nishida K, Maeda S, Anraku Y, Usuku K, Mizuta H. Prediction of postoperative ambulatory status 1 year after hip fracture surgery.ObjectivesTo assess the validity of Estimation of Physiologic Ability and Surgical Stress (E-PASS) for predicting the postoperative risk and ambulatory status long-term follow-up after hip fracture surgery and to establish an algorithm for predicting their ambulatory status.DesignCohort study.SettingTwelve hospitals belonging to the regional network for hip fracture in Japan.ParticipantsThe study population was composed of 421 patients; 268 underwent surgery between April 2004 and March 2006 (group A), and 153 were treated surgically between April 2006 and March 2007 (group B). All were operated at 3 surgical hospitals and, subsequently, transferred to 9 rehabilitation centers.InterventionsNot applicable.Main Outcome MeasuresWe evaluated various factors, including their E-PASS scores to determine whether there was a correlation with the patients' mortality rate and their ability to walk at discharge and 1 year after surgery (group A). Using multiple regression analysis, we then developed algorithms to predict the ability of elderly patients to walk after hip fracture surgery. We applied the algorithms to group B patients and compared their actual and predicted ambulatory status.ResultsIn group A patients, the postoperative walking ability and mortality rate were highly correlated with their E-PASS scores and dementia status. In group B, our algorithms exhibited good correlations between the predicted and actual walking ability at both time points (ρ=0.6, P<.001).ConclusionsIn candidates for hip fracture surgery, the E-PASS scores exhibited a good correlation with the patients' functional and survival prognoses, and the algorithm including E-PASS scores and dementia status can accurately estimate the ambulatory status at discharge and 1 year after surgery. |
| Keywords: | Dementia Hip fractures Mortality Rehabilitation |
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