Long-term functional outcome after a low-energy hip fracture in elderly patients

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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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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Predictors of In-Hospital Ambulatory Status Following Low-Energy Hip Fracture Surgery

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/2151459318814825 ◽

2019 ◽

Vol 10 ◽

pp. 215145931881482 ◽

Cited By ~ 2

Author(s):

Jordan C. Villa ◽

Joseph Koressel ◽

Jelle P. van der List ◽

Matthew Cohn ◽

David S. Wellman ◽

...

Keyword(s):

Peptic Ulcer ◽

Hip Fracture ◽

Peptic Ulcer Disease ◽

Median Time ◽

Low Energy ◽

Ulcer Disease ◽

Time To Surgery ◽

Ambulatory Status ◽

Delayed Time

Introduction: Twenty-five percent to seventy-five percent of independent patients do not walk independently after hip fracture (HF), and many patients experience functional loss. Early rehabilitation of functional status is associated with better long-term outcomes; however, predictors of early ambulation after HF have not been well described. Purposes: To assess the impact of perioperative and patient-specific variables on in-hospital ambulatory status following low-energy HF surgery. Methods: This is a retrospective analysis of 463 geriatric patients who required HF surgery at a metropolitan level-1 trauma center. The outcomes were time to transfer (out of bed to chair) and time to walk. Results: Three hundred ninety-two (84.7%) patients were able to transfer after surgery with a median time of 43.8 hours (quartile range: 24.7-53.69 hours), while 244 (52.7%) patients were able to walk with a median time of 50.86 hours (quartile range: 40.72-74.56 hours). Preinjury ambulators with aids (hazard ratio [HR]: 0.70, confidence interval [CI]: 0.50-0.99), age >80 years (HR: 0.66, CI: 0.52-0.84), peptic ulcer disease (HR: 0.57, CI: 0.57-0.82), depression (HR: 0.66, CI: 0.49- 0.89), time to surgery >24 hours (HR: 0.77, CI: 0.61-0.98), and surgery on Friday (HR: 0.73, CI: 0.56-0.95) were associated with delayed time to transfer. Delayed time to walk was observed in patients over 80 years old (HR: 0.74, CI: 0.56-0.98), females (HR: 0.67, CI: 0.48-0.94), peptic ulcer disease (HR: 0.23, CI: 0.84-0.66), and depression (HR: 0.51, CI: 0.33-0.77). Conclusions: Operative predictors of delayed time to transfer were surgery on Friday and time to surgery >24 hours after admission. Depression is associated with delayed time to transfer and time to walk. These data suggest that is important to perform surgeries within 24 hours of admission identify deficiencies in care during the weekends, and create rehabilitation programs specific for patient with depression. Improving functional rehabilitation after surgery may facilitate faster patient discharge, decrease inpatient care costs, and better long-term functional outcomes.

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Does Early Functional Outcome Predict 1-year Mortality in Elderly Patients With Hip Fracture?

Clinical Orthopaedics and Related Research ◽

10.1007/s11999-013-2955-1 ◽

2013 ◽

Vol 471 (8) ◽

pp. 2703-2710 ◽

Cited By ~ 39

Author(s):

Emilija Dubljanin-Raspopović ◽

Ljiljana Marković-Denić ◽

Jelena Marinković ◽

Una Nedeljković ◽

Marko Bumbaširević

Keyword(s):

Hip Fracture ◽

Elderly Patients ◽

Functional Outcome ◽

Early Functional Outcome

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Early Predictors for Long-Term Functional Outcome After Mild Traumatic Brain Injury in Frail Elderly Patients

Journal of Head Trauma Rehabilitation ◽

10.1097/htr.0000000000000368 ◽

2018 ◽

pp. 1 ◽

Cited By ~ 8

Author(s):

Amaal Eman Abdulle ◽

Myrthe E. de Koning ◽

Harm J. van der Horn ◽

Myrthe E. Scheenen ◽

Gerwin Roks ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Elderly Patients ◽

Functional Outcome ◽

Mild Traumatic Brain Injury ◽

Frail Elderly ◽

Early Predictors

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Correlation between neutrophil-to-lymphocyte ratio and postoperative mortality in elderly patients with hip fracture: a meta-analysis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02831-6 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Yu-Hang Chen ◽

Ching-Hsin Chou ◽

Hsin-Hsien Su ◽

Yu-Ting Tsai ◽

Ming-Hsiu Chiang ◽

...

Keyword(s):

Hip Fracture ◽

Elderly Patients ◽

Geriatric Patients ◽

Meta Analysis ◽

Postoperative Mortality ◽

Short Term ◽

Term Survival ◽

Lymphocyte Ratio ◽

Long Term Mortality

Abstract Introduction The neutrophil-to-lymphocyte ratio (NLR) is a crucial prognosis predictor following several major operations. However, the association between NLR and the outcome after hip fracture surgery is unclear. In this meta-analysis, we investigated the correlation between NLR and postoperative mortality in geriatric patients following hip surgery. Method PubMed, Embase, Cochrane library, and Google Scholar were searched for studies up to June 2021 reporting the correlation between NLR and postoperative mortality in elderly patients undergoing surgery for hip fracture. Data from studies reporting the mean of NLR and its 95% confidence interval (CI) were pooled. Both long-term (≥ 1 year) and short-term (≤ 30 days) mortality rates were included for analysis. Result Eight retrospective studies comprising a total of 1563 patients were included. Both preoperative and postoperative NLRs (mean difference [MD]: 2.75, 95% CI: 0.23–5.27; P = 0.03 and MD: 2.36, 95% CI: 0.51–4.21; P = 0.01, respectively) were significantly higher in the long-term mortality group than in the long-term survival group. However, no significant differences in NLR were noted between the short-term mortality and survival groups (MD: − 1.02, 95% CI: − 3.98 to 1.93; P = 0.5). Conclusion Higher preoperative and postoperative NLRs were correlated with a higher risk of long-term mortality following surgery for hip fracture in the geriatric population, suggesting the prognostic value of NLR for long-term survival. Further studies with well-controlled confounders are warranted to clarify the predictive value of NLR in clinical practice in geriatric patients with hip fracture.

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Relationship between 1,25-dihydroxycholecalciferol levels and functional outcome after hip fracture in elderly patients

Joint Bone Spine ◽

10.1016/j.jbspin.2006.01.029 ◽

2006 ◽

Vol 73 (6) ◽

pp. 729-732 ◽

Cited By ~ 5

Author(s):

Pedro Carpintero ◽

Milagros Garcia-Lazaro ◽

Manuel Montero ◽

Pedro Lopez-Castro ◽

Francisco León ◽

...

Keyword(s):

Hip Fracture ◽

Elderly Patients ◽

Functional Outcome

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Early surgery for Hong Kong Chinese elderly patients with hip fracture reduces short-term and long-term mortality

Hong Kong Medical Journal ◽

10.12809/hkmj165005 ◽

2017 ◽

Cited By ~ 4

Author(s):

Stephanie KK Liu ◽

◽

Angela WH Ho ◽

SH Wong

Keyword(s):

Hong Kong ◽

Hip Fracture ◽

Elderly Patients ◽

Hong Kong Chinese ◽

Early Surgery ◽

Short Term ◽

Chinese Elderly ◽

Long Term Mortality

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Effect of pre-fracture mobility on the early post-operative functional outcome in elderly patients with a hip fracture

South African Journal of Physiotherapy ◽

10.4102/sajp.v69i3.28 ◽

2013 ◽

Vol 69 (3) ◽

Author(s):

S. Adam ◽

L. Godlwana ◽

D. Maleka

Keyword(s):

Hip Fracture ◽

Elderly Patients ◽

Functional Outcome ◽

The Elderly ◽

Functional Mobility ◽

Public Hospitals ◽

Post Discharge ◽

Functional Scale ◽

Post Test ◽

Elderly Mobility

Background: Hip fractures are among the most commoncauses of disability and hospitalisation in the elderly. There are no studies inSouth Africa that determine the effect of pre-fracture functional mobility onearly post-operative functional outcome in elderly patients with a hip fracture.Aim: The aim of this study was to determine the effect of pre-fracture functionalmobility on early post-operative functional outcome in elderly patients with ahip fracture.Methodology: A prospective pre-test post-test observational study designwas done. Assessments were conducted pre-operatively, at discharge and sixweeks post discharge at two public hospitals in Johannesburg, South Africa. Thepre-fracture functional mobility of the participants was determined using theNew Mobility Score (NMS) pre-operatively. At discharge and at six weeks post discharge the participants post-operative functionallevel was assessed using the Elderly Mobility Scale (EMS) and the Lower Extremity Functional Scale (LEFS).Results: More than two thirds of participants were independently mobile prior to the fracture. Pre-fracture functional mobilityis a strong determinant of early post operative functional outcome in elderly patients with a hip fracture(β = 1.39, p = 0.0001).Conclusion: Independent pre-fracture mobility predicts better early post-operative functional outcomes in the elderly.

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