scholarly journals Systematic Review on the Functional Status of Elderly Hip Fracture Patients using Katz Index of Activity of Daily Living (Katz ADL) Score

2020 ◽  
Vol 15 (2) ◽  
Author(s):  
Sharkawi MA ◽  
Zulfarina SM ◽  
Aqilah-SN SMZ ◽  
Isa NM ◽  
Sabarul AM ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Daily Living ◽  
Elderly Population ◽  
Evidence Based ◽  
Activity Of Daily Living ◽  
Inclusion Criteria ◽  
Katz Index ◽  
One Year ◽  
Careful Screening

Hip fractures cases are common in elderly population. After a hip fracture, around 80% of patients were unable to carry out at least one independent activity of daily living (ADL). This review attempted to provide an evidence-based literature on ADL of elderly hip fracture patients. A computerised literature search using Medline (OVID) and Scopus databases were conducted to identify relevant studies on ADL of elderly hip fracture patients that was assessed with Katz ADL score. Only articles that fulfilled the inclusion criteria were included in this review. Initial search identified 314 potentially relevant articles but after careful screening, only 5 full-text articles were selected for the present review. Three studies showed an increase dependent level of the patients’ ADL after hip fractures. Two studies showed not more than half of the patients were unable to regain their pre-fracture ADL level after one year of hip fracture incidence. Feeding/eating showed the highest independent activity while bathing was the lowest independent activity among patients. In conclusion, elderly hip fracture patients have declined ADL with the risk that they may never regain their pre-fracture ADL level.

scholarly journals Hip fracture treatment in Norway

2020 ◽  
Vol 1 (10) ◽  
pp. 644-653
Author(s):  
Cato Kjærvik ◽  
Eva Stensland ◽  
Hanne Sigrun Byhring ◽  
Jan-Erik Gjertsen ◽  
Eva Dybvik ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Hip Fractures ◽  
Best Practice ◽  
Treatment Guidelines ◽  
Treatment Recommendations ◽  
Femoral Neck Fractures ◽  
Evidence Based ◽  
Fracture Treatment ◽  
One Year

Aims The aim of this study was to describe variation in hip fracture treatment in Norway expressed as adherence to international and national evidence-based treatment guidelines, to study factors influencing deviation from guidelines, and to analyze consequences of non-adherence. Methods International and national guidelines were identified and treatment recommendations extracted. All 43 hospitals routinely treating hip fractures in Norway were characterized. From the Norwegian Hip Fracture Register (NHFR), hip fracture patients aged > 65 years and operated in the period January 2014 to December 2018 for fractures with conclusive treatment guidelines were included (n = 29,613: femoral neck fractures (n = 21,325), stable trochanteric fractures (n = 5,546), inter- and subtrochanteric fractures (n = 2,742)). Adherence to treatment recommendations and a composite indicator of best practice were analyzed. Patient survival and reoperations were evaluated for each recommendation. Results Median age of the patients was 84 (IQR 77 to 89) years and 69% (20,427/29,613) were women. Overall, 79% (23,390/29,613) were treated within 48 hours, and 80% (23,635/29,613) by a surgeon with more than three years’ experience. Adherence to guidelines varied substantially but was markedly better in 2018 than in 2014. Having a dedicated hip fracture unit (OR 1.06, 95%CI 1.01 to 1.11) and a hospital hip fracture programme (OR 1.16, 95% CI 1.06 to 1.27) increased the probability of treatment according to best practice. Surgery after 48 hours increased one-year mortality significantly (OR 1.13, 95% CI 1.05 to 1.22; p = 0.001). Alternative treatment to arthroplasty for displaced femoral neck fractures (FNFs) increased mortality after 30 days (OR 1.29, 95% CI 1.03 to 1.62)) and one year (OR 1.45, 95% CI 1.22 to 1.72), and also increased the number of reoperations (OR 4.61, 95% CI 3.73 to 5.71). An uncemented stem increased the risk of reoperation significantly (OR 1.23, 95% CI 1.02 to 1.48; p = 0.030). Conclusion Our study demonstrates a substantial variation between hospitals in adherence to evidence-based guidelines for treatment of hip fractures in Norway. Non-adherence can be ascribed to in-hospital factors. Poor adherence has significant negative consequences for patients in the form of increased mortality rates at 30 and 365 days post-treatment and in reoperation rates. Cite this article: Bone Joint Open 2020;1-10:644–653.

Hip Fracture Treatment in Oulu — One-Year Survey with Four-Month Follow-Up

2006 ◽  
Vol 95 (1) ◽  
pp. 61-67 ◽  
Author(s):  
I. Saarenpää ◽  
T. Heikkinen ◽  
J. Partanen ◽  
P. Jalovaara
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Reoperation Rate ◽  
Gamma Nail ◽  
University Hospital ◽  
Fracture Treatment ◽  
Trochanteric Fractures ◽  
Cervical Fractures ◽  
Walking Aids ◽  
One Year

Backgrounds and Aims: The standardized forms of the Standardized Audit of Hip Fractures in Europe (SAHFE) are aimed for the evaluation of hip fracture treatment in different hospitals and countries. The purpose was to evaluate and characterize a cohort of hip fracture patients with these forms and to evaluate their value in quality control. Material and Methods: The non-pathological hip fractures in patients over 49 years of age treated in the Oulu University Hospital were prospectively recorded during a one-year period using SAHFE forms. Results: There were 238 (52 male and 186 female) patients with a mean age of 78 (50–102) years. Fifty-nine percent of the patients were admitted from their own homes. Fifty-seven percent were able to walk alone outdoors and 48% could walk without walking aids before the fracture. A hundred and fifty patients had cervical fractures and 88 trochanteric fractures. The most frequent treatment of cervical fractures was Austin-Moore hemiarthroplasty (68%) and that of trochanteric fractures Gamma nail fixation (86%). At four months after the fracture, 50% lived in their own homes, 33% could walk alone out-doors and 13% could walk without any aids. Thirty-two percent had no pain in the hip. The overall mortality at four months was 17.6% and that of the operated patients 16.2%. The reoperation rate was 8.5%. Conclusion: SAHFE forms were very useful in the evaluation of the quality of the hip fracture treatment.

scholarly journals 07 Rehabilitation in Patients with Dementia Following Hip Fracture

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Cliona Small ◽  
Emma Lennon ◽  
Rebecca Low ◽  
Rachael Doyle ◽  
Shane O'Hanlon
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Admission Rate ◽  
Clinical Frailty Scale ◽  
Admission Rates ◽  
People With Dementia ◽  
Diagnosis Of Dementia ◽  
The Mean ◽  
One Year ◽  
Lost To Follow Up

Abstract Background Hip fractures are an increasing phenomenon in the older population. Receiving post-operative rehabilitation is associated with better outcomes and a higher likelihood of returning to preexisting level of functioning. Best rehabilitation practices for people with dementia have not been established. Methods All patients >/= 60 years old with a hip fracture admitted under the orthopaedic team between March 2016-February 2018 were reviewed. Those with a diagnosis of dementia were extracted from the database. Clinical Frailty Scale (CFS), Zuckermann Functional Recovery Score (FRS) and New Mobility Score (NMS) were documented at baseline and at one year. Outcomes assessed included 1 year mortality, decline FRS/NMS, change in CFS and nursing home (NH) admission rates. Results 465 patients’ hip fractures were recorded: 175 patients had dementia. 67 patients were dead at 1-year post fracture (38.285% mortality rate). Of the 108 patients with dementia who were living at 1-year; 30.5% (n=33) received offsite rehab. 58.4% (n=63) received routine in-patient rehab. 12 lost to follow-up. Of the 33 patients that received off-site rehab the mean FRS at baseline was 66 and decreased to 45.56 at 1 year (30.9% reduction). The mean CFS at baseline was 5.1, increasing to 6 at 1-year (17% increase). Mean NMS was 5.7 decreasing to 3.7 at 1-year. In those patients with dementia that did not receive off site rehab (n=63); baseline mean FRS was 38 reducing to 30 at 1 year (26.6 % reduction). Mean CFS was 6.25- increasing to 6.47 at 1 year. 41% of patients admitted from home who did not receive off-site rehab were discharged to NH. Of the group discharged to off-site rehab: at 1 year 33% were in a NH and 72% remained at home. Conclusion Both groups demonstrated decline in function. Those that received off-site rehab had higher premorbid functioning/mobility and reduced frailty. There was a reduced NH admission rate at 1-year in the group that received off-site rehab.

scholarly journals Inpatient hip fractures: understanding and addressing the risk of this common injury

2020 ◽  
Vol 49 (3) ◽  
pp. 481-486 ◽  
Author(s):  
Inderpal Singh ◽  
Kate Hooton ◽  
Chris Edwards ◽  
Beverley Lewis ◽  
Anser Anwar ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Care Home ◽  
Patient Characteristics ◽  
Health Board ◽  
Falls Risk ◽  
Inpatient Falls ◽  
One Year ◽  
Home Placement ◽  
The Impact

Abstract Introduction The impact and outcome of hip fractures are well described for people living in the community, but inpatient hip fracture (IHF) have not been extensively studied. In this study, we examine the patient characteristics, common falls risk factors and clinical outcomes of this condition. Methods Between January 2016 and December 2017, we analysed all inpatient falls that resulted in hip fracture within Aneurin Bevan University Health Board (ABUHB) in Wales. Results The overall falls rate was 8.7/1000 occupied bed days (OBD). Over the 2 years, 118 patients sustained an IHF, giving a rate of 0.12/1000 OBD. The mean age was 81.8 ± 9.5 (range 49–97) years and 60% were women. Most patients (n = 112) were admitted from their own home. Mean Charlson Comorbidity Index and the number of medications on admission were 5.5 ± 1.9 and 8.5 ± 3.7, respectively. Fifty-three patients (45%) sustained the IHF following their first inpatient fall. Twenty-four IHF (20%) occurred within 72 h. Mean length of stay was 84.9 ± 55.8 days. Only 43% were discharged back to their original place of residence following an IHF; 27% were discharged to a care home (26 new care home discharges), and 30% died as an inpatient. One-year mortality was 54% (n = 64/118). The most common comorbidity was dementia (63%). Conclusion Mortality and need for care home placement are both much higher after IHF than following community hip fracture. Most people who suffer a hip fracture in hospital have already demonstrated their need for falls risk management by having fallen previously during the same admission.

scholarly journals The Relationship between Visual Constructive Abilities and Activity of Daily Living in Home Dwelling Elderly Population

Salmand ◽  
2016 ◽  
Vol 11 (2) ◽  
pp. 220-225 ◽  
Author(s):  
Negin Chehrehnegar ◽  
Fariba Keshavarzi ◽  
Negar Rahnamaee ◽  
Zahra Aghajafari
Keyword(s):  
Daily Living ◽  
Elderly Population ◽  
Activity Of Daily Living ◽  
The Relationship

scholarly journals MORTALITY AND FUNCTION AFTER SURGICALLY-TREATED HIP FRACTURE IN ADULTS YOUNGER THAN AGE 60

2017 ◽  
Vol 25 (4) ◽  
pp. 129-131 ◽  
Author(s):  
Babak Pourabbas ◽  
Mohammad Jafar Emami ◽  
Amir Reza Vosoughi ◽  
Hamideh Mahdaviazad ◽  
Zeinab Kargarshouroki
Keyword(s):  
Young Adults ◽  
Hip Fracture ◽  
Mortality Rate ◽  
Hip Fractures ◽  
Functional Outcomes ◽  
Pain Severity ◽  
Walking Aids ◽  
One Year ◽  
The One

ABSTRACT Objective: Hip fractures in young adults can cause poor functional capacity throughout life because of several complications. The purpose of this study was to prospectively evaluate 1-year mortality and functional outcomes for patients aged 60 years or younger with hip fracture . Methods: We prospectively obtained data for all consecutive patients aged 60 or younger with any type of hip fracture who were treated operatively between 2008 and 2014. After one year, patient outcomes were evaluated according to changes in pain severity, functional status (modified Barthel index), and mortality rate . Results: Of the total of 201 patients, 132 (65.7%) were men (mean age: 41.8 years) and 69 (34.3%) were women (mean age: 50.2 years) (p<0.001). Reduced pain severity was reported in 91.5% of the patients. The mean modified Barthel index was 22.3 in men and 18.6 in women (p<0.001). At the one-year follow-up, 39 cases (19.4%) were dependent on walking aids while only 17 patients (8.5%) used walking aids preoperatively (p<0.001). Seven patients (4 men and 3 women) died during the one-year follow-up period; 2 died in the hospital after surgery . Conclusion: Hip fractures in young adults have a low mortality rate, reduction in pain severity, and acceptable functional outcomes one year after surgery. Level of Evidence II, Prospective Comparative Study.

scholarly journals Identifying Disparities in the Management of Hip Fractures Within Europe: A Comparison of 3 Health-Care Systems

2019 ◽  
Vol 10 ◽  
pp. 215145931987294 ◽  
Author(s):  
Cliodhna E. Murray ◽  
Andreas Fuchs ◽  
Heide Grünewald ◽  
Owen Godkin ◽  
Norbert P. Südkamp ◽  
...  
Keyword(s):  
Health Care ◽  
Hip Fracture ◽  
Hip Fractures ◽  
Care Pathway ◽  
Health Care Systems ◽  
Standards Of Care ◽  
Evidence Based ◽  
Care Hospital ◽  
Care Systems ◽  
The Uk

Introduction: This study investigates the management of hip fractures in a German maximum care hospital and compares these data to evidence-based standard and practice in 180 hospitals participating in the UK National Hip Fracture Database (NHFD) and 16 hospitals participating in the Irish Hip Fracture Database (IHFD). This is the first study directly comparing the management of hip fractures between 3 separate health-care systems within Europe. Methods: Electronic medical data were collected retrospectively describing the care pathway of elderly patients with a hip fracture admitted to a large trauma unit in the south of Germany “University Hospital Freiburg” (UHF). The audit evaluated demographics, postoperative outcome, and the adherence to the 6 “Blue Book” standards of care. These data were directly compared with the data from the UK NHFD and the IHFD acquired from 180 and 16 hospitals, respectively. Results: At 36 hours, 95.8% of patients had received surgery in UHF, compared to 71.5% in the NHFD and 58% of patients in the IHFD. The rate of in-hospital mortality was 4.7% compared to 7.1% in the NHFD and 5% in the IHFD. The mean average acute length of stay was 13.4 days compared to 16.4 days in the NHFD and 20 days in the IHFD. Reoperation rates are 3.3% compared to 1% in the NHFD and 1.1% in the IHFD; 50.5% of patients were discharged on bone protection medication, compared to 47% in the IHFD and 79.3% in the UK NHFD. Discussion: Despite uniformly acknowledged evidence-based treatment guidelines, the management of hip fractures remains heterogeneous within Europe. Conclusion: These data show that different areas of the hip fracture care pathway in Germany, England, and Ireland, respectively, show room for improvement in light of the growing socioeconomic burden these countries are expected to face.

Medical management of hip fractures and the role of the orthogeriatrician

2012 ◽  
Vol 22 (4) ◽  
pp. 261-273 ◽  
Author(s):  
Abhaya Gupta
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Evidence Based ◽  
Effective Management ◽  
Vulnerable Group ◽  
Management Guidelines ◽  
Operative Complications ◽  
Orthopaedic Ward ◽  
Time Of Admission

SummaryPublished literature shows that evidence-based medical care can improve hip fracture outcomes. The orthogeriatrician plays a key role in providing this care, in collaboration with surgical and multidisciplinary professionals, managing pre-operative conditions and post-operative complications that may affect functional recovery, and ensuring co-ordinated effective management of hip fractures right from admission to discharge. Several management guidelines are available for this vulnerable group of elderly patients. Recent UK guidelines recommend that, from time of admission, hip fracture patients should be offered a formal acute orthogeriatric or orthopaedic ward-based ‘Hip Fracture Programme’, which includes orthogeriatric assessment as an essential key component.

Sign in / Sign up

Export Citation Format

Share Document