Research Article: Determinants of ambulatory ability after hip fracture surgery in Japan and the USA

Abstract

We examined the relationship of the length of stay and the day of initiating partial weight bearing to patients' level of ambulatory ability at 3 months after hip fracture surgery in Japan and the USA. The participants were patients aged > or = 65 years who had undergone hip fracture surgery between August 2005 and September 2007. The data were collected from three hospitals in Japan and two hospitals in the USA. The participants received questionnaires pertaining to patient health outcomes after discharge. One-hundred-and-forty-nine patients in Japan and 88 patients in the USA completed the questionnaire. In Japan, the length of stay before surgery was longer and partial weight bearing after surgery was initiated later, compared to the USA. This independently predicted a lower level of ambulatory ability at 3 months after surgery. Assessing the reasons for delaying surgery and partial weight bearing is important in Japan. Encouraging ambulation with weight bearing at the earliest possible time is essential for patients to maintain their ambulatory ability after hip fracture surgery. Prospective studies using a large sample and/or intervention studies are required to determine the causal effect on ambulatory ability.

Relationship between admission day and timing of surgery for patients with hip fracture

“…On the contrary, patients who underwent surgery at 5 days or later after admission experienced better survival (Kondo, Zierler, & Hagino, ). However, with the same study participants, a longer LOS before surgery was associated with lower ambulatory ability at 3 months after surgery (Kondo, Hagino, & Zierler, ). Therefore, providers should reduce unnecessary delays before surgery, and they should carefully identify patients who are not suitable for early surgery (Kondo, Hagino, & Zierler, ).…”

Nursing Care after Hip Fracture Surgery Predicts Patient Ambulatory Ability at 3 Months after Surgery

“…In this study, the initial date for partial weight bearing was as early as it was in US hospitals, based on a previous study [12]. However, nursing care for weight bearing was not implemented with as many patients as was nursing care for getting out of bed.…”

“…In addition, an early initial date of weight bearing after surgery predicts a higher ambulatory ability at 3 months after surgery [12]. This study examined 1) whether nursing care that encourages patients getting out of bed predicts incidence of complications or mortality, 2) whether nursing care that encourages patients to bear weight predicts ambulatory ability at discharge and 3 months after surgery, and 3) whether nursing care predicts LOS after surgery.…”

Mobility, Remobilisation, Exercise and Prevention of the Complications of Stasis

“…Surgeons usually decide when to allow restricted or full weight bearing [6], with a mean time for an order for ambulation of 2 days, as some hesitate because of concerns about mechanical failure [7]. However, delay in weight bearing has been connected to poor function [8]. With current implants and surgical techniques, most patients can be allowed to weight bear and movements (e.g.…”