Prediction of ambulation prognosis in the elderly after hip fracture

Abstract

We investigated the factors influencing ambulation prognosis after hip fracture in the elderly patient and examined whether it is possible to predict the ambulation status upon hospital discharge at the time of admission. Two hundred and five patients aged 60 or older with a hip fracture who were ambulant before injury were studied. The patients were divided into two groups according to their ability to walk at the time of discharge from hospital: the ambulatory group and the non-ambulatory group. We assessed the value of various predictive factors. At discharge, 136 patients (66.3%) were ambulatory while 69 patients (33.7%) were non-ambulatory. Factors significantly affecting walking ability at discharge were: (1) age, (2) dementia, (3) residence before injury, (4) anaemia, (5) electrolyte abnormality, (6) abnormal chest X-ray, and (7) chronic systemic disease. Each patient was scored on the basis of the above factors (1=yes, 0=no), and the total was used as the predictive score. The mean score was significantly higher (p<0.0005) in the non-ambulatory group. It is possible to predict ambulation prognosis after hip fracture using our scoring system at the time of admission.

Predictive factors of mortality and deterioration in performance of activities of daily living after hip fracture surgery in Kagoshima, Japan

“…For those older patients who survive a hip fracture, there are also effects on their functional status. The prognosis of hip fractures is influenced by age, prefracture function and lifestyle, pre‐existing comorbidities, cognitive impairment, fracture site, pain, anemia, electrolyte abnormalities, and muscle strength . The outcome of fracture interventions is influenced by the admitting hospital, patient status and patient selection criteria.…”

Comparison of the prognosis among different age groups in elderly patients with hip fracture

“…The factors influencing walking ability after treatment include age, pre-injury walking ability, status of dementia, and status of chronic systemic disease 46. Holt et al 7.…”

Efficacy of early surgery and causes of surgical delay in patients with hip fracture

“…We selected surgery up to day 1 after admission as early surgery because in most studies, early intervention is defined as surgery performed within 24 h after admission or injury. 13 Next, we analyzed 23 parameters as potential factors that delay surgery or affect postsurgical outcome: age at admission gender, pre-injury residence, pre-injury ambulatory ability, day of admission (admission during weekend/public holiday), fracture site (femoral neck fracture or trochanteric fracture), fracture type (stable or unstable type), results of blood tests and urinalysis at admission, chest radiographic abnormalities, electrocardiographic abnormalities, number of systemic chronic diseases, 23 status of dementia, surgical modality (osteosynthesis or femoral head replacement), status of blood transfusion, postoperative complication (requiring treatment by specialists other than orthopedic surgeon), length of hospital stay, ambulatory ability at discharge, and hospital death ( Table 1).…”