Association between longitudinal clinical outcomes in patients with hip fracture and their pre‐fracture place of residence

Abstract

Background: Clinical outcomes of patients with proximal femoral fracture within 1 year after hospitalization are presented. In particular, associations between the patients' clinical status and their pre-fracture residence were evaluated (community-dwelling vs nursing home). Methods: Patients aged ≥60 years with proximal femoral fractures were included in a prospective, single-centre observational study and followed for 12 months. Patients' clinical status at baseline was compared to their health status at follow-up 12 months later. Several standardized questionnaires were used to evaluate the patients' functional and cognitive capacity (e.g. Lawton Instrumental Activities of Daily Living Scale, Barthel Index, and Mini-Mental State Examination), mobility (timed up-and-go test, Tinetti Test, and Harris Hip Score), quality of life (EuroQol-5 Dimensions index and EuroQol Visual Analogue Scale), and psychological status (Geriatric Depression Scale).Results: This study included 402 patients (mean age: 81.3 AE 8.2 years, 72% women). Patients stayed in hospital for 13.7 AE 6.1 days on average. The comparison of patients' clinical status at baseline and at 12-month follow-up revealed that the Mini-Mental State Examination and Charlson Comorbidity Index remained unchanged (P = 0.527 and P = 0.705), the level of depression (Geriatric Depression Scale) significantly decreased (P < 0.001), and quality of life (EuroQol-5 Dimensions index) diminished (P < 0.001). Although patients' mobility increased after 12 months (P < 0.001 for timed up-and-go test and Harris Hip Score), their functional capacity was significantly reduced (P < 0.001 for Barthel Index and Lawton Instrumental Activities of Daily Living Scale). Nursing home residents showed a significantly higher impairment at baseline than communitydwelling individuals and less improvement in functional and cognitive tests at 12-month follow-up. Conclusions: Clinical outcomes after hip fracture are significantly associated with patients' pre-fracture residence status. Place of residence as well as functional and cognitive status on admission may lead to differences in functional recovery and affect therapeutic and rehabilitative decisionmaking.

Objectively Measured Physical Activity and Its Association with Functional Independence, Quality of Life and In-Hospital Course of Recovery in Elderly Patients with Proximal Femur Fractures: A Prospective Cohort Study

“…e need for these adjusted algorithms and appropriate tracker devices is in accordance with studies, showing distinctive validity for different wearables and intensities [32,33]. e clinical improvement observed between operation and discharge could be documented with a similar quality as the usually applied indices for quality of life (EQ5D) and functional independence (Barthel-20), which are regarded as the current gold standard [34]. However, only the measured activity parameters of the highest level out of 4 corresponding with actual walking or active or very active minutes were able to delineate this development.…”

Evaluation of Quality of Life After Nonoperative or Operative Management of Proximal Femoral Fractures in Frail Institutionalized Patients

“…A proximal femoral fracture further diminishes HRQoL. Among nursing home residents who were surgically treated for their injury, the mean (SD) EQ-5D utility scores at 3 months after the injury decreased from 0.6 (0.2) to 0.35 (0.24) in a Canadian study and 0.43 (0.34) to 0.39 (0.35) in a German study . The EQ-5D utility scores in the current study were even lower, most likely because of the added criteria of frailty.…”

Effect of Combining Operating Room Nursing Based on Clinical Quantitative Assessment with WeChat Health Education on Postoperative Complications and Quality of Life of Femoral Fracture Patients Undergoing Internal Fixation

“…With the abundant resource of femoral fracture patients undergoing internal fixation, our hospital had rich experience in operating room nursing and found that routine operating room nursing placed emphasis on the doctor's procedure with the main purpose of assisting the doctor to finish the procedure, and so did the clinical practice, so routine operating room nursing was passive and limited to some extent and could not meet the gradually increasing nursing needs from current social and medical development. The clinical quantitative assessment strategy is the condition quantitative assessment scale generated on the basis of the evidence-based medicine and evidence level, which can fully consider the individual situation of patients and carry out multidimensional evaluation to perform systematic nursing intervention according to the physiological and psychological status of patients, making clinical nursing more scientific, comprehensive, and efficient [ 21 – 24 ]. To further improve the clinical nursing level of our hospital, WeChat health education was implemented for femoral fracture patients during the perioperative period, which promoted the intensity of nursing intervention and obviously improved patients' psychological state, self-care ability, etc.…”