Factors influencing the progress of mobilization in hip fracture patients during the early postsurgical period?—A prospective observational study

Buecking, Benjamin; Bohl, Katharina; Eschbach, Daphne; Bliemel, Christopher; Aigner, René; Balzer‐Geldsetzer, Monika; Dodel, Richard; Ruchholtz, Steffen; Debus, Florian

doi:10.1016/j.archger.2015.01.017

Cited by 51 publications

(43 citation statements)

References 33 publications

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“…proclaimed that an early operation leads to reduced complications and higher survival rate. While an early operation seems to reduce the rate of complications, and a reduction of 36 to 24 hours before the operation raises the rate of survival, we aimed to achieve an early treatment. Within 24 hours of injury, 58% of our patients were surgically supplied, which is close to comparable studies.…”

Section: Discussionmentioning

confidence: 99%

Hip Fractures: Therapy, Timing, and Complication Spectrum

Saul

Riekenberg

Ammon

et al. 2019

Orthopaedic Surgery

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ObjectiveInvestigation of the treatment of femur fractures and the type of femur fracture‐associated complications regarding timing of surgery and length of hospital stay.MethodsIn this retrospective cohort study, a total of 358 hip fractures were evaluated retrospectively from 1 January 2008 until 31 December 2010 at a level I trauma center in Germany. Inclusion criteria was age >18 years and a proximal femur fracture. Both sexes were evaluated. Mean age was 75.5 years, most patients were female (63.7%). Intervention was the operative treatment of proximal femur fracture. Outcome parameters were time until surgery, complications, reoperations, mortality, and length of hospital stay.ResultsAmong the proximal femur fractures (n = 358), 46.6% were pertrochanteric, 11.2% subtrochanteric, and 42.2% femoral neck fractures. Operation upon hip fractures was managed regularly within 24 hours of injury (73%; mean for femoral neck: 28.3 hrs.; mean for pertrochanteric fractures: 21.4 hrs.; mean for subtrochanteric fractures: 19.5 hrs.). Delayed treatment, as well as implantation of hip total endoprosthesis (TEP), increased the overall length of hospital stay (15.4 vs 17.6 days; 18.1 vs 15.8 days). Accordingly, surgical procedures performed within 24 hours of injury resulted in a shorter hospital residence. Longest delay of operation was measured for hip fractures (28.3 hrs.).In 351 patients, secondary injuries were detected in 94 individuals (26%), with fractures being the most common secondary injury (n = 40). We recorded postoperative complications of nonsurgical and surgical origin, and 33.6% of our patient cohort displayed complications. Complications were distributed among 118 patients. There was no significant difference in complications regarding the time of operation, with most nonsurgical and surgical complications appearing within 24 hours after operation (n = 110 vs n = 31). Nonsurgical complications, such as anemia (n = 49) and electrolyte imbalances (n = 30), were observed more frequently than surgical complications (n = 107 vs n = 34); however, these complications were reduced by delay in surgery (82.0% in 6–24 hrs. vs 74.2% in ≥24 hrs.). Anticoagulant therapy and age did not affect postoperative complications. The hospital mortality of patients was 6.2%. Follow‐up was restrained to ambulatory visits in the clinic.ConclusionsSurgical management of hip fractures performed within 24 hours of injury minimizes hospital stay. We did not detect significant differences in the spectrum or number of complications regarding delay of surgery. Surgical complications mainly occur with rapid primary care, and medical complications can be reduced by more intensive preparation of patient and operation procedures.

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Section: Discussionmentioning

confidence: 99%

Hip Fractures: Therapy, Timing, and Complication Spectrum

Saul

Riekenberg

Ammon

et al. 2019

Orthopaedic Surgery

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“…Follow up was obtained during hospitalization, and 6 months, 1 year and 5 years after surgery. Mortality, comorbidities, complications, clinical course and short‐term follow up have already been published in some publications of our study group . As a result, the methodology has already been described several times.…”

Section: Methodsmentioning

confidence: 99%

“…Mortality, comorbidities, complications, clinical course and short-term follow up have already been published in some publications of our study group. [17][18][19][20] As a result, the methodology has already been described several times. This allows us to focus only on the methodology of the current data analysis.…”

Section: Methodsmentioning

confidence: 99%

Development of the Barthel Index 5 years after hip fracture: Results of a prospective study

Knauf

Buecking

Hack

et al. 2019

Geriatrics Gerontology Int

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Aim The importance of proximal femoral fractures is increasing due to demographic change. Despite appropriate care, these are associated with poor results. We are still lagging behind, and require information on the long‐term functional outcome of these patients and the predictive factors involved. Methods Between 2009 and 2011, 402 patients aged >60 years with hip fractures were included in this prospective observational study. Patients were assessed with the Barthel Index before fracture, at discharge, and 6 months, 1 year and 5 years after surgery. In addition, a variety of parameters (sex, age, fracture type, American Society of Anesthesiologists classification, Mini‐Mental State Examination, housing situation, occurrence of complications during inpatient stay and type of care) were collected to identify the possible independent predictive factors using multivariate analysis. Results The lowest Barthel Index was found at discharge (66 ± 24) for patients from an acute hospital. The Barthel Index improved within the first 6 months (86 ± 21) and decreased afterwards. The factors associated with a significantly higher point loss of the Barthel Index in the multivariate analysis were age (P‐value 0.020), pre‐fracture Barthel Index, (P ≤ 0.001), Mini‐Mental State Examination (P ≤ 0.001) and type II complications (P = 0.001). The other values showed no significant influence on the Barthel Index. Conclusions The present results showed that patients after a hip fracture have a great rehabilitation potential within the first 6 months after the event. More attention should be paid to type II complications and the occurrence of cognitive impairment. Both seem to be a surrogate parameter for the frailty of the patients. Geriatr Gerontol Int 2019; 19: 809–814.

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“…A wealth of research has been performed leading to advances in care for this vulnerable group. Implementation of multidisciplinary clinical pathways, have resulted in improvements including; decreased mortality, time to surgery, post-operative complications, length of stay as well as facilitating functional recovery [3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

See me, teach me, guide me, but it’s up to me! Patients’ experiences of recovery during the acute phase after hip fracture

Asplin

Carlsson

Olsén

et al. 2019

European Journal of Physiotherapy

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Aim: To explore patients' experiences of their recovery after hip fracture surgery and the use of Traffic Light System-BasicADL in their rehabilitation process. Method: Nineteen patients (13 females and 6 males), aged 66-94, were interviewed. A qualitative content analysis method was used for analysis of data. Results: Two categories were identified: 'Being seen as a person' with subcategories; Interaction affects trust and security; Information is key to understanding; and Encouragement is essential to promote activity. And 'Striving for Independence', with subcategories; Accepting the situation while trying to remain positive; The greener the better, but it's up to me; Ask me, I have goals; and Uncertainties concerning future. Conclusion: The findings of this study mirror clinical reality. There is a continued need for organisations to reflect over existing practise and question routines and procedures. In order to improve services and provide better quality of care, it is essential to acknowledge the patients' experiences, needs and preferences and make efforts to accommodate these where possible. Health care professionals must recognise that patients with hip fracture are individuals, with varying needs that change across the continuum of recovery. ARTICLE HISTORY

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Factors influencing the progress of mobilization in hip fracture patients during the early postsurgical period?—A prospective observational study

Cited by 51 publications

References 33 publications

Hip Fractures: Therapy, Timing, and Complication Spectrum

Hip Fractures: Therapy, Timing, and Complication Spectrum

Development of the Barthel Index 5 years after hip fracture: Results of a prospective study

See me, teach me, guide me, but it’s up to me! Patients’ experiences of recovery during the acute phase after hip fracture

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