Delay in hip fracture surgery and its outcomes. A reflection

Hip fracture is one of the major public healthcare problems in elderly patients around the world, mainly because of the risk of falls and osteoporosis which are typical during this stage of life, and may be the cause for up to 36% of deaths among those affected. Its management in principle is surgical and the best results are achieved with patients undergoing surgery during the first 24 to 72 after the fracture. Any delays in surgery are mostly associated with decompensated personal pathological factors, delays in perioperative assessment, or in presurgical complementary tests; sometimes, the delays are the result of administrative formalities of the healthcare providers. These determining factors may affect both morbidity and mortality, and contribute to functional decline, disability, and reduced quality of life of these patients. A third party intervention is then necessary to improve the preventable factors that delay the osteosynthesis in these types of fractures, in addition to ensuring education, infrastructure, inputs, skilled human resources, and prompt referral of patients from the first level of care. Investigating this scenario and assessing the quality of life impact on these patients should be a priority.

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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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Preoperative Anemia, Functional Outcomes, and Quality of Life After Hip Fracture Surgery

Journal of the American Geriatrics Society ◽

10.1111/jgs.15428 ◽

2018 ◽

Vol 66 (8) ◽

pp. 1524-1531 ◽

Cited By ~ 11

Author(s):

Yilin Eileen Sim ◽

Shao-en David Sim ◽

Chusheng Seng ◽

Tet Sen Howe ◽

Suang Bee Koh ◽

...

Keyword(s):

Quality Of Life ◽

Hip Fracture ◽

Functional Outcomes ◽

Preoperative Anemia ◽

Hip Fracture Surgery ◽

Fracture Surgery

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EFFECTS OF FRAGILITY FRACTURE INTEGRATED REHABILITATION MANAGEMENT HIP FRACTURE IN PAKISTANI OLDER ADULTS

QUALITY OF LIFE IN PATIENTS WITH NEUROGENIC COMMUNICATION DISORDER ◽

10.52567/trj.v5i01.55 ◽

2021 ◽

Vol 5 (1) ◽

pp. 192-197

Author(s):

Anam Aftab ◽

◽

Shaista Habibullah ◽

Nimra Ilyas Bhutta ◽

◽

...

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Hip Fracture ◽

Fragility Fracture ◽

Personal Hygiene ◽

Walking Ability ◽

Rehabilitation Management ◽

Hip Fracture Surgery ◽

Fracture Surgery

Objective: to evaluate the effectiveness of fragility Fracture Integrated Rehabilitation Management (FIRM) on older adults of Pakistan after hip fracture surgery. Methodology: A one-group pretest–posttest designwas conducted at the National Institute of Rehabilitation Medicine (NIRM), Islamabad from March 2020 to May 2021.. A n=11 participants with age above 55 years, both male and female, with confirming diagnosed cases of hip fracture were included. Every participats receveied 10 sesssions of Fragility Fracture integrated Rehabilitation Management (FIRM) program in two weeks. Data was collected at baseline at 2nd day and after 10th session on 15th day, through the KOVAL scale to assess the walking ability, the Functional Ambulatory Category (FAC) to assess the level of independence, the modified Barthel index (MBI) for activities of daily living (ADLs), and quality of life (QoL) was assessed by EQ-5D. Data were analyzed by using SPSS Version 21. Result: the mean age 76.45±9.32, of which n=6 (54.6%) were males and n=5(45.4%) were females. after 10th sessions the QoL on EQ-5D, ambulation on FAC and KOVAL scale and the ADL on MBI were significantly improved (p<0.05) with large effect size, except for the anxiety domain of EQ5D and subdomains of MBI; Personal hygiene, feeding, Bowel control, bladder control, Wheelchair, and Chair & bed transfer showed no significant change (p>0.05). Conclusion: FIRM care is found to be effective in improving the walking ability, functional status, ADLs and quality of life in geraiatric population following a hip fracture surgery

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