Handgrip Strength is an Independent Predictor of Functional Outcome in Hip-Fracture Women

Background: Hip fractures are a major public health concern among elderly individuals. This study aimed to investigate potential perioperative factors that predict 1-year functional outcome, quality of life (QoL), care demands, and mortality in geriatric patients with a hip fracture. Methods: We prospectively enrolled geriatric patients who had undergone hip fracture surgery in one medical center from December 2017 to December 2019. Basic demographic data, handgrip strength, and responses to questionnaires for QoL and activities of daily living (ADL) before the injury were collected at baseline. QoL, ADL, additional care demands other than family support, and mortality events were monitored at 1 year after the operation. Results: Among 281 patients with a hip fracture, 39 (13.9%) died within 1 year of the index operation. The mean follow-up interval for the survivors was 403.3 (range: 358–480) days. Among the 242 survivors, ADL and QoL considerably decreased at approximately 1 year following hip surgery. Up to 33.9% of the participants became severely dependent and needed additional care at 1-year follow up. Prefracture ADL status was the crucial predictor for functional outcome, QoL, and additional care demand at 1-year follow up. Cox regression models indicated that male sex, low preoperative serum creatinine, handgrip strength, long surgical delay after a falling accident, and high Charlson Comorbidity Index were considerably associated with a high 1-year mortality risk in the geriatric hip fracture population. Conclusion: Hip fracture has long-lasting effects (e.g. functional loss, decline in QoL, increased care demands, and high postoperative mortality rate) on the geriatric population. A robust screening method must be developed for identifying potential prognostic factors, and a stratified care approach must be used that accounts for personalized risks to improve functional outcomes and reduce mortality after hip fracture in geriatric patients, especially in Taiwan.

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Identification of hip fracture patients at risk for postoperative mobilisation complications via handgrip strength assessment

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-021-03756-9 ◽

2021 ◽

Author(s):

Johannes Gleich ◽

Daniel Pfeufer ◽

Alexander M. Keppler ◽

Stefan Mehaffey ◽

Julian Fürmetz ◽

...

Keyword(s):

Hip Fracture ◽

Gait Speed ◽

Handgrip Strength ◽

Weight Bearing ◽

Proximal Femur Fracture ◽

Term Outcome ◽

Long Term Outcome ◽

Strength Assessment ◽

Positive Correlation ◽

Prospective Study Design

Abstract Introduction Treatment of older adult hip fracture patients can be challenging and requires early postoperative mobilisation to prevent complications. Simple clinical tools to predict mobilisation/weight-bearing difficulties after hip fracture surgery are scarcely available and analysis of handgrip strength could be a feasible approach. In the present study, we hypothesised that patients with reduced handgrip strength show incapability to follow postoperative weight-bearing instructions. Materials and methods Eighty-four patients aged ≥ 65 years with a proximal femur fracture (trochanteric, n = 45 or femoral neck, n = 39), who were admitted to a certified orthogeriatric center, were consecutively enrolled in a prospective study design. Five days after surgery (intramedullary nailing or arthroplasty), a standardised assessment of handgrip strength and a gait analysis (via insole forcesensors) was performed. Results Handgrip strength showed positive correlation with average peak force during gait on the affected limb (0.259), postoperative Parker Mobility Score (0.287) and Barthel Index (0.306). Only slight positive correlation was observed with gait speed (0.157). These results were congruent with multivariate regression analysis. Conclusion Assessment of handgrip strength is a simple and reliable tool for early prediction of postoperative mobilisation complications like the inability to follow weight-bearing instructions in older hip fracture patients. Follow-up studies should evaluate if these findings also match with other fracture types and result in personalised adjustment of current aftercare patterns. In addition, efforts should be made to combine objectively collected data as handgrip strength or gait speed in a prediction model for long-term outcome of orthogeriatric patients.

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Functional outcome and survival after hip fracture in elderly: a prospective study of 106 consecutive patients

Journal of Orthopaedics and Traumatology ◽

10.1007/s10195-004-0033-x ◽

2004 ◽

Vol 5 (1) ◽

pp. 7-14 ◽

Cited By ~ 13

Author(s):

I. Nurmi ◽

A. Narinen ◽

P. L�thje ◽

S. Tanninen

Keyword(s):

Hip Fracture ◽

Prospective Study ◽

Functional Outcome ◽

A Prospective Study

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The impact of cognitive impairment at admission on short-term functional outcome of elderly hip fracture patients

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1006319d ◽

2010 ◽

Vol 138 (5-6) ◽

pp. 319-322 ◽

Cited By ~ 4

Author(s):

Emilija Dubljanin-Raspopovic ◽

Dragana Matanovic ◽

Marko Bumbasirevic

Keyword(s):

Cognitive Impairment ◽

Hip Fracture ◽

Elderly Patients ◽

Functional Outcome ◽

Cognitive Status ◽

Cognitively Impaired ◽

Short Term ◽

Functional Gain ◽

The Impact ◽

Cognitively Intact

Introduction The number of patents with dementia increases among hip fracture patients. Cognitive dysfunction is defined as a premorbid state which is potentionally negatively related to short-term functional outcome. Objective To assess the relationship between cognitive status on admission and functional gain during an early rehabilitation period in elderly hip fracture patients. Methods Forty-five elderly patients with surgically treated hip fracture were examined. Cognitive status was assessed by the Mini Mental State Examination (MMSE) at admission; functional status was assessed by the motor subscale of Functional Independence Measure (FIM) at admission and before discharge, while absolute functional gain was determined by the motor FIM gain (FIM discharge - FIM admission). Absolute functional gain was analyzed in respect to cognitive status. Results Both cognitively impaired and cognitively intact hip fracture patients exhibited overall FIM motor improvements, as well as functional gains in specific FIM motor areas (p<0.01). Absolute functional gain, however, was higher in 1) cognitively intact compared to cognitively impaired patients (p<0.01), and 2) cognitively moderately impaired patients compared to severely cognitively impaired patients (p<0.01). No difference in functional gain was detected between the patients with moderately cognitively impaired compared to the cognitive intact patients (p>0.05). Conclusion The systematic use of MMSE identifies cognitively impaired hip fracture patients, and effectively predicts their short-term functional outcome. A higher admission cognitive status is related to a more favorable short term rehabilitation outcome. In spite of cognitive impairment, elderly patients with hip fracture can benefit from participation in rehabilitation programmes. The systematic identification of cognitively impaired hip fracture patients at admission facilitates optimal treatment and rehabilitation, and thus enables the best achievable outcome to be reached.

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Low ankle-brachial index is an independent predictor of poor functional outcome in acute cerebral infarction

Atherosclerosis ◽

10.1016/j.atherosclerosis.2012.06.058 ◽

2012 ◽

Vol 224 (1) ◽

pp. 113-117 ◽

Cited By ~ 16

Author(s):

Jinkwon Kim ◽

Dong Hyun Lee ◽

Myoung-Jin Cha ◽

Tae-Jin Song ◽

Ji Hye Park ◽

...

Keyword(s):

Cerebral Infarction ◽

Functional Outcome ◽

Independent Predictor ◽

Ankle Brachial Index ◽

Acute Cerebral Infarction ◽

Poor Functional Outcome

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Handgrip Strength Predicts Persistent Walking Recovery After Hip Fracture Surgery

The American Journal of Medicine ◽

10.1016/j.amjmed.2013.04.017 ◽

2013 ◽

Vol 126 (12) ◽

pp. 1068-1075.e1 ◽

Cited By ~ 55

Author(s):

Elisabetta Savino ◽

Emilio Martini ◽

Fulvio Lauretani ◽

Giulio Pioli ◽

Anna Maria Zagatti ◽

...

Keyword(s):

Hip Fracture ◽

Handgrip Strength ◽

Hip Fracture Surgery ◽

Walking Recovery ◽

Fracture Surgery

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Simultaneous Hip and Distal Radius Fractures—Does It Make a Difference with Respect to Rehabilitation?

Geriatrics ◽

10.3390/geriatrics4040066 ◽

2019 ◽

Vol 4 (4) ◽

pp. 66

Author(s):

Emilija Dubljanin-Raspopović ◽

Marković-Denić Lj ◽

Marko Kadija ◽

Sanja Tomanović Vujadinović ◽

Goran Tulić ◽

...

Keyword(s):

Hip Fracture ◽

Functional Outcome ◽

Hip Fractures ◽

Wrist Fracture ◽

Wrist Fractures ◽

Short And Long Term ◽

Actual Incidence ◽

Prospective Investigation

Introduction: A minority of patients with hip fractures sustain concomitant wrist fractures. Little is known about the rehabilitation outcome in this group of patients. Aim of study: Prospective investigation of functional outcome and survival in patients with combined hip and wrist fractures compared with patients who sustain an isolated hip fracture. Methods: 341 patients who presented with an acute hip fracture during a 12 month period were included in the study. Outcome at discharge and 4 months follow-up was compared between patients with isolated hip fractures and those patients who sustained simultaneous distal wrist fractures. Results: The actual incidence of concurrent hip and wrist fractures in our cohort was 4.7%. Patients who sustained a concurrent hip and wrist fracture showed no differences regarding short- and long-term functional outcome and survival. Conclusion: Our results imply that patients with simultaneous hip and wrist fractures have no difference in rehabilitative outcome. Future studies should further investigate the distinctive characteristics of this patient subgroup.

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