Patient-reported outcomes at acute hospital stay and four months after hip fracture surgery. A register and questionnaire study

2018 ◽  
Vol 6 (1) ◽  
pp. 119
Author(s):  
Berit Gesar ◽  
Carina Baath ◽  
Hanne Hedin ◽  
Ami Hommel

Introduction: The large and increasing number of hip fracture patients, in combination with the large impact that this is having on daily living activities, is emphasizing the importance of identifying factors that have a detrimental impact on post-operative outcomes. There are benefits to planning the ward in a way that prevents a steep decline in recovery after hip fracture surgery. Adding the patient`s perspective into the healthcare assessment, via shared healthcare decision-making, allows the patient’s needs and preferences to be taken fully into account. The aim of this study was to identify factors that predict how patients recover after hip fracture surgery.Methods: A descriptive quality register/questionnaire study in acute orthopaedic wards, 2 to 5 days after surgery, with a follow-up 4 months later. The patients included were ≥65 years of age and had been previously healthy and living independently before the hip fracture.Results: The participants in this study had returned to their own homes after 4 months, but only 21% reported themselves as being fully or almost fully recovered. In several domains of recovery, all 3 age groups (65-74, 75-84 and 85-97) reported different challenges both during their acute hospital stay and at the 4 months follow-up. The recovery phase is heterogeneous and requires individual care. The way that this is planned has an influence on patient outcome.Conclusion: Patients sustaining a hip fracture are heterogeneous and different age groups experience different challenges. At 4 months follow-up, one fifth of the participants reported themselves fully or almost fully recovered and most of them had returned to their own homes. The Swedish National Hip Fracture Register and the patient-reported questionnaires employed in this study are appropriate tools to audit further development of healthcare to improve quality of life after hip fracture surgery.

Geriatrics ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 8
Author(s):  
Morten Tange Kristensen ◽  
Signe Hulsbæk ◽  
Louise Lohmann Faber ◽  
Lise Kronborg

To examine if knee-extension strength (KES) measures indicating probable sarcopenia are associated with health-related outcomes and if KES and hand grip strength (HGS) measures are associated with 1-year mortality after hip fracture. Two groups of older patients with hip fracture had either HGS (n = 32) or KES (n = 150) assessed during their acute hospital stay. Cut-points for HGS (<27 kg for men and <16 kg for women), and cut-points for maximal isometric KES (non-fractured limb), being the lowest sex-specific quintile (<23.64 kg for men and <15.24 kg for women), were used to examine association with health-related outcomes and 1-year mortality. Overall, 1-year mortality was 12.6% in the two strength groups, of which 47% (HGS) and 46% (KES) respectively, were classified as probable sarcopenia. Probable sarcopenia patients (KES) had lower prefracture function, performed poorly in mobility measures and expressed a greater concern of falling compared to their stronger counterparts. Hazard ratio for 1-year mortality was 2.7 (95%CI = 0.49–14.7, p = 0.3) for HGS and 9.8 (95%CI = 2.2–43.0, p = 0.002) for KES for probable sarcopenia patients compared to those not. Sex-specific KES measures indicating sarcopenia is associated with health-related outcomes and a strong predictor of 1-year mortality after hip fracture.


2022 ◽  
Vol 12 (1) ◽  
pp. 102
Author(s):  
Ming-Hsiu Chiang ◽  
Yu-Yun Huang ◽  
Yi-Jie Kuo ◽  
Shu-Wei Huang ◽  
Yeu-Chai Jang ◽  
...  

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.


2020 ◽  
pp. 1357633X2093243
Author(s):  
Cabbee TL Li ◽  
Goris KN Hung ◽  
Kenneth NK Fong ◽  
Pablo Cruz Gonzalez ◽  
Shu-hong Wah ◽  
...  

Introduction This study aimed to investigate the effects of a home-based occupational therapy telerehabilitation (TR) via smartphone in enhancing functional and motor performance and fall efficacy for outpatients receiving day hospital rehabilitation after hip fracture surgery in Hong Kong. Methods This was a feasibility randomised controlled trial with two groups – an experimental group and a comparison group – and a sample of 31 older adults attending a geriatric day hospital who had undergone hip fracture surgery within 12 weeks of diagnosis. Patients were assessed at baseline, immediately after a three-week intervention and at three-week post-intervention follow-up for motor performance, activities of daily living (ADL) functioning and fall efficacy. The experimental group received a home programme using the Caspar Health e-system and a mobile app for smartphones, while the comparison group received paper-and-pencil instructions for the home programme on a weekly basis for three weeks. Results Compared to the comparison group, significant improvements in fall efficacy and instrumental ADL performance at post intervention and follow-up were found in the experimental group. However, in the comparison group, inadequate social support was a factor contributing to better muscle strength testing in both the affected and non-affected legs. There were no significant differences between the two groups in regard to the other variables. Discussion This study supports the potential use of TR via smartphone as an alternative home programme for use in occupational therapy practice with older adults after hip fracture surgery.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Pierre Huette ◽  
Osama Abou-Arab ◽  
Az-Eddine Djebara ◽  
Benjamin Terrasi ◽  
Christophe Beyls ◽  
...  

Maturitas ◽  
2012 ◽  
Vol 72 (3) ◽  
pp. 225-228 ◽  
Author(s):  
Jorien M. Willems ◽  
Anton J.M. de Craen ◽  
Rob G.H.H. Nelissen ◽  
Peter A. van Luijt ◽  
Rudi G.J. Westendorp ◽  
...  

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