Poster 81: Outcomes for Older Adults in an Inpatient Rehabilitation Facility Following Hip Fracture Surgery

Abstract Background: Older adults who sustain hip fractures encounter physical and functional decline after discharge from inpatient rehabilitation. Currently, a synthesis of literature is lacking on health and social supports that may impact outcomes in the community-dwelling older adults, post-discharge from rehabilitation. Methodology: We conducted a systematic review to a) evaluate how health and social supports influence outcomes for older adults and their caregivers following inpatient rehabilitation post-hip fracture surgery, and b) identify the factors that affect their impact on outcomes. We searched Medline, CINAHL, Embase, Emcare, Psychinfo, and Ageline for publications between 2000 and 2018. We followed Cochrane Handbook methods to screen titles and abstracts, appraise quality, collect data and synthesize results. Results: A total of 3364 articles were retrieved, and 34 studies were included for final synthesis, including 24 randomized control trials and 10 observational studies. Most studies excluded persons with moderate or severe cognitive impairment. Interventions can be broadly categorized as either comprehensive care delivered by interdisciplinary teams focusing on exercise, nutrition and fracture prevention; or exercise sessions delivered by health professionals, trained instructors or volunteers. Interventions involving interdisciplinary teams demonstrated moderate improvement of mobility and functional ability in the first 3 months. However, the longitudinal effects of interventions were not realized for all. Conclusion: This review provides evidence of the effectiveness of health and social supports provided to older adults post-hip fracture. We are uncertain of the applicability to people with cognitive decline due to exclusion from most studies. Implications for practice and research will be discussed.

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For older adults recovering from hip fracture surgery, what are the effects of multinutrient supplements?

Cochrane Clinical Answers ◽

10.1002/cca.2174 ◽

2018 ◽

Author(s):

Jane Burch ◽

Sera Tort

Keyword(s):

Older Adults ◽

Hip Fracture ◽

Hip Fracture Surgery ◽

Fracture Surgery

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Sarcopenia index based on serum creatinine and cystatin C predicts the risk of postoperative complications following hip fracture surgery in older adults

BMC Geriatrics ◽

10.1186/s12877-021-02522-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xiaoyan Chen ◽

Yanjiao Shen ◽

Lisha Hou ◽

Binyu Yang ◽

Birong Dong ◽

...

Keyword(s):

Older Adults ◽

Hip Fracture ◽

Postoperative Complications ◽

Serum Creatinine ◽

Cystatin C ◽

Binary Logistic Regression ◽

Joint Replacement Surgery ◽

Hip Fracture Surgery ◽

Replacement Surgery ◽

Fracture Surgery

Abstract Objective To assess the utility of the preoperative Sarcopenia index (SI) as a predictive marker of the risk of postoperative complications following hip fracture surgery in older adults. Study design This observational study enrolled older adults with hip fracture who were hospitalized in the Department of Orthopedics of West China Hospital, Sichuan University, from December 7, 2010 - June 14, 2017, and who underwent hip fracture surgery. Primary outcome and measures Clinical data were collected from medical records and serum creatinine and cystatin C were measured before surgery. Outcomes included postoperative complications such as pneumonia, urinary tract infection, respiratory failure, heart failure, and non-grade A healing. Binary logistic regression analyses were used to analyze association between SI and postoperative complications. Results A total of 897 patients aged 60 years and over were enrolled in this study (age range: 60 – 100 years), of whom 306(34.1%)were male, and 591(65.9%)were female. Postoperative complications included pneumonia (12%), urinary tract infections (1.8%), respiratory failure (1.5%), heart failure (1.6%), and non-A- grade healing (3.6%). In the patient group that received joint replacements, the incidence of pneumonia was negatively associated with SI values. After adjusting for potential confounding factors, binary logistic regression analyses showed that a higher SI was independently associated with a lower risk of pneumonia after joint replacement surgery (OR:0.39, 95% CI:0.18-0.89, P<0.05). However, we did not find statistically significant association between SI and the risk of postoperative complications other than pneumonia among patients with two types of hip fracture surgery. Conclusion The SI based on serum creatinine and cystatin C can predict pneumonia rather than other postoperative complications among older patients with hip fracture after joint replacement surgery.

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Inpatient knee pain after hip fracture surgery affects gait speed in older adults: A retrospective chart‐referenced study

Geriatrics and Gerontology International ◽

10.1111/ggi.14255 ◽

2021 ◽

Author(s):

Yoichi Kaizu ◽

Kazuhiro Miyata ◽

Hironori Arii ◽

Takehiko Yamaji

Keyword(s):

Older Adults ◽

Hip Fracture ◽

Knee Pain ◽

Gait Speed ◽

Hip Fracture Surgery ◽

Fracture Surgery

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Older adults’ perceptions of early rehabilitation and recovery after hip fracture surgery: a UK qualitative study

Disability and Rehabilitation ◽

10.1080/09638288.2020.1783002 ◽

2020 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Jessica Southwell ◽

Chris Potter ◽

David Wyatt ◽

Euan Sadler ◽

Katie Jane Sheehan

Keyword(s):

Older Adults ◽

Hip Fracture ◽

Qualitative Study ◽

Early Rehabilitation ◽

Hip Fracture Surgery ◽

Fracture Surgery

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Prognostic Factors for Mortality, Activity of Daily Living and Quality of Life in Taiwanese Older Patients within 1 Year following Hip Fracture Surgery

Journal of Personalized Medicine ◽

10.3390/jpm12010102 ◽

2022 ◽

Vol 12 (1) ◽

pp. 102

Author(s):

Ming-Hsiu Chiang ◽

Yu-Yun Huang ◽

Yi-Jie Kuo ◽

Shu-Wei Huang ◽

Yeu-Chai Jang ◽

...

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Hip Fracture ◽

Daily Living ◽

Estimating Equation ◽

Generalized Estimating Equation ◽

Hip Fracture Surgery ◽

Fracture Surgery

Background. Hip fractures among older adults are a major public health concern worldwide. This study investigated the potential clinical factors that predict postoperative 1-year activities of daily living (ADL), quality of life (QoL), and mortality in Taiwanese older adults following hip fracture. Methods. This is a prospective cohort study enrolling older adults (≥60 years) who had undergone hip fracture surgery in a single medical center. The comprehensive clinical history of each patient was examined. QoL, ADL, and mortality events were recorded consecutively at 3, 6, and 12 months after operation. The multiple logistic regression model and the generalized estimating equation (GEE) were adopted to identify contributing factors for mortality and postoperative ADL and QoL prognosis, respectively. Results. Among 377 participants with hip fracture, 48 died within 1 year of the index operation. ADL and QoL considerably decreased at 3 months following hip surgery. Old age, high Charlson Comorbidity Index, and American Society of Anesthesiologists grading were crucial predictors for mortality at the 1-year follow-up. The generalized estimating equation analysis indicated that the length of postoperative follow-up time, serum albumin level, patient cognitive status, and handgrip strength were considerably associated with QoL and ADL recovery prognosis in the Taiwanese older adults following hip fracture. Conclusions. Hip fractures have long-lasting effects on the older adults. Our data imply several prognosis predicting parameters that may assist clinicians in accounting for an individual’s personalized risks in order to improve functional outcomes and reduce mortality.

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