scholarly journals No Major Differences in Recovery After Hip Fracture Between Home-Dwelling Female and Male Patients

2019 ◽  
Vol 109 (3) ◽  
pp. 250-264
Author(s):  
A. Lahtinen ◽  
J. Leppilahti ◽  
H. Vähänikkilä ◽  
S. Kujala ◽  
J. Ristiniemi ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Activities Of Daily Living ◽  
Mortality Risk ◽  
Daily Living ◽  
Walking Ability ◽  
Residential Status ◽  
Men And Women ◽  
Male Patients ◽  
American Society ◽  
American Society Of Anesthesiologists

Background: Studies comparing recovery of men and women after hip fracture have reported conflicting results, some reporting worse recovery in male patients, while others found no differences between genders. Methods: Recovery was compared in 105 male and 433 female patients with hip fractures and in age-matched groups of patients 50 years or older, who were home-dwelling and received similar rehabilitation. Residential status, walking ability, hip pain and activities of daily living function were recorded at admission and 4 and 12 months postoperatively, along with mortality and re-operations. Results: No differences were observed between men and women 4 and 12 months postoperatively regarding residential status (p = 0.181 vs p = 0.883), mortality rates (p = 0.232 vs p = 0.880) or total activities of daily living scores (p = 0.546 vs p = 0.435). Walking ability was better among male patients prefracture (p < 0.001) and 4 and 12 months after fracture (p < 0.001, p = 0.031, respectively). In age-matched pair analysis, no differences were found regarding mortality, residential status, walking ability, or ADL score. Cox regression analysis identified mortality risk factors as being age, prefracture ADL score, American Society of Anesthesiologists score 4–5 and place of rehabilitation. Sex was not mortality risk factor. Interpretation: Home-dwelling male and female patients had similar courses of recovery from hip fracture, although there were singular differences in specific activities of daily living functions and postoperative pain. There were no differences in mortality, even when prefracture characteristics were considered. Mortality was higher among older patients and who had high American Society of Anesthesiologists scores and low prefracture activities of daily living scores.

scholarly journals Effects of fragility fracture integrated rehabilitation management on mobility, activity of daily living and cognitive functioning in elderly with hip fracture

2020 ◽  
Vol 36 (5) ◽  
Author(s):  
Anam Aftab ◽  
Waqar Ahmed Awan ◽  
Shaista Habibullah ◽  
Jae Young Lim
Keyword(s):  
Hip Fracture ◽  
Activities Of Daily Living ◽  
Cognitive Functioning ◽  
Fragility Fracture ◽  
Daily Living ◽  
Stair Climbing ◽  
Walking Ability ◽  
Bipolar Hemiarthroplasty ◽  
Activity Of Daily Living ◽  
Rehabilitation Management

Objective: To determine the effectiveness of Fragility Fracture Integrated Rehabilitation Management (FIRM) on mobility, activity of daily living and cognitive functioning in elderly with hip fracture. Methods: A randomized control trial was conducted at Seoul National University Bundang Hospital, South Korea from August 2017 to January 2018. Patients of both genders with the age 65-95 years, diagnosed cases of hip fracture specifically fractures neck of femur, intertrochanteric, subtrochantric, patients who got bipolar hemiarthroplasty, total hip replacement arthroplasty, reduction and internal fixation were included in this study. A total of n=39 sample was collected through non probability convenience sampling technique and randomly divided into Fragility Integrated Rehabilitation Management (FIRM) group (n=20) and Conventional Physical therapy (CPT) group (n=19). The data was collected through KOVAL for walking ability, modified barthal index (MBI) for behaviors related to activities of daily living (ADLS) and mini mental status examination (MMSE) for cognitive functions at baseline on 2nd postoperative day and after 10th FIRM session on 15th postoperative day. Results: The mean age of study participants was 82.07±6.00 years. The post intervention comparison did not show any significant difference (p>0.05) in walking ability, overall ADLs and cognitive functioning. But FIRM group showed significant improvement in stair climbing {0(5) ver. 2(7.5), p=0.049} and ambulation or walker use {8(5) ver. 2(4), p=0.037}, as compared to CPT group. Conclusion: Both groups improved in indoor mobility with walker and crutches as well as activities of daily living. But FIRM showed more improving ambulation with walker and stair climbing. While cognitive functioning was observed only in FIRM group. ClinicalTrials.gov Identifier: NCT03430193. https://clinicaltrials.gov/ct2/show/NCT03430193. doi: https://doi.org/10.12669/pjms.36.5.2412 How to cite this:Aftab A, Awan WA, Habibullah S, Lim JY. Effects of fragility fracture integrated rehabilitation management on mobility, activity of daily living and cognitive functioning in elderly with hip fracture. Pak J Med Sci. 2020;36(5):---------.   doi: https://doi.org/10.12669/pjms.36.5.2412 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Improved outcome in hip fracture patients in the aging population following co-managed care compared to conventional surgical treatment: a retrospective, dual-center cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Carl Neuerburg ◽  
Stefan Förch ◽  
Johannes Gleich ◽  
Wolfgang Böcker ◽  
Markus Gosch ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Activities Of Daily Living ◽  
Trauma Care ◽  
Daily Living ◽  
Aging Population ◽  
Readmission Rates ◽  
Term Outcome ◽  
Long Term Outcome

Abstract Background Hip fracture patients in the aging population frequently present with various comorbidities, whilst preservation of independency and activities of daily living can be challenging. Thus, an interdisciplinary orthogeriatric treatment of these patients has recognized a growing acceptance in the last years. As there is still limited data on the impact of this approach, the present study aimed to evaluate the long-term outcome in elderly hip fracture patients, by comparing the treatment of a hospital with integrated orthogeriatric care (OGC) with a conventional trauma care (CTC). Methods We conducted a retrospective, two-center, cohort study. In two maximum care hospitals all patients presenting with a hip fracture at the age of ≥ 70 years were consecutively assigned within a 1 year period and underwent follow-up examination 12 months after surgery. Patients treated in hospital site A were treated with an interdisciplinary orthogeriatric approach (co-managed care), patients treated in hospital B underwent conventional trauma care. Main outcome parameters were 1 year mortality, readmission rate, requirement of care (RC) and personal activities of daily living (ADL). Results A total of 436 patients were included (219 with OGC / 217 with CTC). The mean age was 83.55 (66–99) years for OGC and 83.50 (70–103) years for CTC (76.7 and 75.6% of the patients respectively were female). One year mortality rates were 22.8% (OGC) and 28.1% (CTC; p = 0.029), readmission rates were 25.7% for OGC compared to 39.7% for CTC (p = 0.014). Inconsistent data were found for activities of daily living. After 1 year, 7.8% (OGC) and 13.8% (CTC) of the patients were lost to follow-up. Conclusions Interdisciplinary orthogeriatric management revealed encouraging impact on the long-term outcome of hip fracture patients in the aging population. The observed reduction of mortality, requirements of care and readmission rates to hospital clearly support the health-economic impact of an interdisciplinary orthogeriatric care on specialized wards. Trial registration The study was approved and registered by the bavarian medical council (BLAEK: 7/11192) and the local ethics committee of munich university (Reg. No. 234–16) and was conducted as a two-center, cohort study at a hospital with integrated orthogeriatric care and a hospital with conventional trauma care.

scholarly journals Increasing Education-Based Disparities in Healthy Life Expectancy Among U.S. Non-Hispanic Whites, 2000–2010

2019 ◽  
Author(s):  
Phillip Cantu ◽  
Connor M Sheehan ◽  
Isaac Sasson ◽  
Mark D Hayward
Keyword(s):  
Life Expectancy ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
White Men ◽  
Mortality Rates ◽  
Healthy Life ◽  
Men And Women ◽  
Specific Mortality ◽  
Disability Prevalence ◽  
College Educated

Abstract Objectives To examine changes in Healthy Life Expectancy (HLE) against the backdrop of rising mortality among less educated white Americans during the first decade of the 21st century. Method This study documented changes in HLE by education among U.S. non-Hispanic whites, using data from the U.S. Multiple Cause of Death public-use files, the Integrated Public Use Microdata Sample (IPUMS) of the 2000 Census and the 2010 American Community Survey, and the Health and Retirement Study (HRS). Changes in HLE were decomposed into contributions from: (1) change in age-specific mortality rates; and (2) change in disability prevalence, measured via Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). Results Between 2000 and 2010, HLE significantly decreased for white men and women with less than 12 years of schooling. By contrast, HLE increased among college-educated white men and women. Declines or stagnation in HLE among less educated whites reflected increases in disability prevalence over the study period, whereas improvements among the college educated reflected decreases in both age-specific mortality rates and disability prevalence at older ages. Discussion Differences in HLE between education groups increased among non-Hispanic whites from 2000 to 2010. In fact, education-based differences in HLE were larger than differences in total life expectancy. Thus, the lives of less educated whites were not only shorter, on average, compared with their college-educated counterparts, but they were also more burdened with disability.

scholarly journals FUNCTIONAL INDEPENDENCE, ACCESS TO KIDNEY TRANSPLANTATION, AND WAITLIST MORTALITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S494-S495
Author(s):  
Nadia M Chu ◽  
Stephanie Sison ◽  
Abimereki Muzaale ◽  
Christine Haugen ◽  
Jacqueline Garonzik Wang ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Kidney Disease ◽  
Activities Of Daily Living ◽  
Competing Risks ◽  
Mortality Risk ◽  
Daily Living ◽  
Functional Independence ◽  
End Stage Kidney Disease ◽  
End Stage ◽  
Waitlist Mortality

Abstract Although functional independence is a health priority for patients with advanced CKD, 50% of those who progress to end-stage kidney disease (ESKD) develop difficulties carrying-out essential day-to-day activities. Functional independence is not routinely assessed at kidney transplant (KT) evaluation; therefore, it is unclear what percentage of candidates are functionally independent and whether independence is associated with access to KT and waitlist mortality. We studied a prospective cohort of 3,168 ESKD participants (1/2009-6/2018) who self-reported functional independence in basic Activities of Daily Living (ADL) and more complex Instrumental Activities of Daily Living (IADL). We estimated adjusted associations between functional independence (separately) and listing (Cox), waitlist mortality (competing risks), and transplant rates (Poisson). At evaluation, 92.4% were independent in ADLs, but only 68.5% were independent in IADLs. Functionally independent participants had a higher chance of listing for KT (ADL:aHR=1.55,95%CI:1.30-1.87; IADL:aHR=1.39,95%CI 1.26-1.52). Among KT candidates, ADL independence was associated with lower waitlist mortality risk (SHR=0.66,95%CI:0.44-0.98) and higher rate of KT (IRR=1.58,95%CI:1.12-2.22); the same was not observed for IADL independence (SHR=0.86,95%CI:0.65-1.12; IRR=1.01,95%CI:0.97-1.19). ADL independence was associated with better KT access and lower waitlist mortality; clinicians should screen KT candidates for ADL independence, and identify interventions to maintain independence to improve waitlist outcomes.

scholarly journals Variation in timely surgery for hip fracture by day and time of presentation: a nationwide prospective cohort study from the National Hip Fracture Database for England, Wales and Northern Ireland

2020 ◽  
pp. bmjqs-2020-011196
Author(s):  
Anjali Shah ◽  
Gulraj S Matharu ◽  
Dominic Inman ◽  
Elizabeth Fagan ◽  
Antony Johansen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Northern Ireland ◽  
Population Based ◽  
Quality Healthcare ◽  
Adjusted Risk ◽  
Hip Fracture Surgery ◽  
Average Patient ◽  
American Society ◽  
American Society Of Anesthesiologists

Background and ObjectiveSeveral studies report poorer quality healthcare for patients presenting at weekends. Our objective was to examine how timely surgery for patients with hip fracture varies with day and time of their presentation.MethodsThis population-based cohort study used 2017 data from the National Hip Fracture Database, which recorded all patients aged 60 years and over who presented with a hip fracture at a hospital in England, Wales and Northern Ireland. Provision of prompt surgery (surgery within 36 hours of presentation) was examined, using multivariable logistic regression with generalised estimating equations to derive adjusted risk ratios (RRs). Time was categorised into three 8-hour intervals (day: 08:00–15:59, evening: 16:00–23:59 and night: 00:00–07:59) for each day of the week. The model accounted for clustering by hospital and was adjusted by sex, age, fracture type, operation type, American Society of Anesthesiologists grade, preinjury mobility and location.ResultsWe studied 68 977 patients from 177 hospitals. The average patient presenting during the day on Friday or Saturday was significantly less likely to undergo prompt surgery (Friday during 08:00–15:59, RR=0.93, 95% CI 0.91 to 0.96; Saturday during 08:00–15:59, RR=0.91, 95% CI 0.88 to 0.94) than patients in the comparative category (Thursday, during the day). Patients presenting during the evening (16:00–23:59) were consistently significantly less likely to undergo prompt surgery, and the effect was more marked on Fridays and Saturdays (Friday during 16:00-23:59, RR=0.83, 95% CI 0.80 to 0.85; Saturday during 16:00–23:59, RR=0.81, 95% CI 0.78 to 0.85). Patients presenting overnight (00:00–07:59), except on Saturdays, were significantly more likely to undergo surgery within 36 hours (RR>1.07).ConclusionThe provision of prompt hip fracture surgery was complex, with evidence of both an ‘evening’ and a ‘night’ effect. Investigation of weekly variation in hip fracture care is required to help implement strategies to reduce the variation in timely surgery throughout the entire week.

The effect of having a partner on activities of daily living in men and women aged 82–87 years

Maturitas ◽  
2011 ◽  
Vol 68 (3) ◽  
pp. 286-290 ◽  
Author(s):  
Nancy A. Pachana ◽  
Deirdre McLaughlin ◽  
Janni Leung ◽  
Samantha J. McKenzie ◽  
Annette Dobson
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Men And Women
Sign in / Sign up

Export Citation Format

Share Document