Frailty defined by 19 items as a predictor of short-term functional recovery in patients with hip fracture |
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| Affiliation: | 1. Department of Rehabilitation, Kobe City Nishi-Kobe Medical Centre, 5-7-1, Kojidai, Nishiku, Kobe, Hyogo, Japan;2. Konan Women''s University, Faculty of Nursing and Rehabilitation, 2-23-6, Morikita-machi, Higashinadaku, Kobe, Japan;3. Department of Rehabilitation, Saiseikai Hyogoken Hospital, 5-1-1, Fujiwaradai nakamachi, Kitaku, Kobe, Japan;4. Department of Community Health Science, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma, Japan;1. The Swedish Hip Arthroplasty Register, Registercentrum Västra Götaland, SE-413 45 Gothenburg, Sweden;2. Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, R-huset, plan 4, Mölndals sjukhus, Göteborgsvägen 31, 431 80 Mölndal, Sweden;3. Lidköping Hospital, Sweden. Department of Orthopaedics, Mellbygatan 11-15, 531 85 Lidköping, Sweden;1. Trauma Surgery Group of Santa Casa de São Paulo, Brazil;2. Department of Orthopedics and Traumatology, Santa Casa de São Paulo, Brazil;3. Neuromuscular Diseases Group of Santa Casa de São Paulo, Brazil;4. Orthopaedics and Traumatology Department of Irmandade da Santa Casa de Misericóridia de São Paulo, Brazil;1. Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52074 Aachen, Germany;2. Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Switzerland;3. AO Research Institute Davos, Switzerland;4. Department of Foot and Ankle Surgery, Catholic Hospital Mainz, Germany;5. Research Centre for Musculoskeletal Science & Sports Medicine, Faculty of Science and Engineering, School of Healthcare Science, Manchester Metropolitan University, Manchester, United Kingdom;6. Department of Radiology, University Hospital RWTH Aachen, Germany;7. Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Germany;8. Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Germany;1. The Ottawa Hospital – Civic Campus, 1053 Carling Avenue, Suite J129, Ottawa, Ontario, Canada;2. Forte Hospital, 132 Peterborough Street, Christchurch Central, Christchurch, New Zealand;3. University of Calgary, Canada;1. Department of Trauma Surgery, Regensburg University Medical Center, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany;2. Academic Department of Trauma @ Orthopedic Surgery, School of Medicine, University of Leeds, Leeds, UK |
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| Abstract: | IntroductionMany hip fracture patients have decreased functional status inhibiting recovery to pre-fracture functional status. The prevalence of frailty in patients with hip fracture is high, but little is known how frailty is associated with functional recovery. The aim of this study was to determine whether frailty can predict functional recovery and clinical outcomes during the acute phase in hip fracture.Patients and MethodsThis study was retrospective observational study from two acute hospitals. Participants were recruited from hip fracture patients who underwent surgery. The main exposure was frailty defined using 19-item modified Frailty Index (mFI). The main outcome was functional recovery, evaluated by postoperative efficiency on the motor-Functional Independence Measure (FIM) score. Secondary outcomes included postoperative complication and discharge disposition. Multiple logistic regression analyses were performed using each outcome as a dependent variable and mFI as an independent variable.ResultsSample included 274 patients (mean age 83.7 ± 7.4 years, female 80.7%). Patients with higher mFI exhibited lower functional recovery, defined by efficiency on the motor-FIM score, and tended to run into complications and not return home (P < .001). In multiple logistic regression analyses, higher mFI was significantly associated with increased likelihood of lower functional recovery (odds ratio [OR], 1.60; 95% CI, 1.32–1.93; P < .001), occurrence of postoperative complication (OR, 1.32; 95% CI, 1.13–1.54; P < .001) and not returning home (OR, 1.77; 95% CI, 1.38–2.26; P < .001).ConclusionsFrailty defined by 19-item mFI can predict short-term functional recovery during acute phase following hip fracture. Frailty is also associated with postoperative complication and discharge disposition. |
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