Functional Outcome After Hip Fracture in Japan

Predictors of Prognosis for Elderly Patients with Poststroke Hemiplegia Experiencing Hip Fractures

“…Youm et al [43] showed the functional recovery of elderly patients with a prior stroke who experience a hip fracture was similar to that of patients without a prior stroke when controlling for prefracture level of function. We found 68.5% of patients with hemiplegia who were surviving at the 1-year followup and were not nonfunctional ambulators before the fracture returned to their prefracture ambulatory status, which is similar to the result reported by Kitamura et al [22]. In the preliminary analysis, we found gender, ASA rating, number of comorbidities, and cognitive ability influenced recovery of prefracture ambulatory status, however, gender disappeared in the multivariate logistic regression, which is consistent with the results of other studies [17,24] ( Table 9).…”

“…Patients with three or more comorbidities [40] or Category III or IV ASA rating generally possess inferior physical capacity, and consequently, their rehabilitation training is limited. Several studies have shown dementia decreases the likelihood of recovery of prefracture ambulatory status [17,22,27], a finding our study confirms. Because patients with severe dementia have poor motivation and are unable to follow instructions, it is difficult for them to complete the rehabilitation schedule [22,27].…”

“…Several studies have shown dementia decreases the likelihood of recovery of prefracture ambulatory status [17,22,27], a finding our study confirms. Because patients with severe dementia have poor motivation and are unable to follow instructions, it is difficult for them to complete the rehabilitation schedule [22,27]. Therefore, patients with three or more comorbidities, Category III or IV ASA rating, or moderate to severe dementia were less likely to regain their prefracture ambulatory status.…”

“…Prefracture and postfracture ambulation levels were classified based on standard definitions of community, home, and nonfunctional ambulators [22,39]. For purposes of a more detailed analysis, these categories were further subdivided (Table 2) [22,39].…”

Association between Acute Postoperative Pain and Recovery of Independent Walking Ability after Surgical Treatment of Hip Fracture

“…7) In fact, it has been reported that only about 50% of patients reach their preinjury independent walking ability at 1 year postfracture, with restriction in performing instrumental ADL being particularly notable among elderly individuals. [8][9][10] In their prospective evaluation of independent walking ability after hip fracture treatment among 753 patients in Japan, Tsuboi et al reported a decrease in the proportion of individuals who were able to walk independently outdoors, with or without an assistive device, from 68% (514 patients) prior to fracture to 56% (340 patients) at 1 year postfracture and 63% (125 patients) at 10 years postfracture. 11) Fracture-related pain is associated with lower functional status at discharge from the hospital and poor overall functional prognosis.…”