Survival and Functional Outcomes after Hip Fracture among Nursing Home Residents

Abstract

Following the implementation of a long-term care insurance system for the elderly in Korea, many nursing homes have been established and many more patients than ever before have been living at nursing homes. Despite the fact that this is a high-risk group vulnerable to hip fractures, no study has yet been conducted in Korea on hip fracture incidence rates and prognoses among patients residing at nursing homes. We recently studied 46 cases of hip fracture in nursing homes; more specifically, we investigated the most common conditions under which fractures occur, and examined the degree of recovery of ambulatory ability and the mortality within 1 yr. Among those who had survived after 1 yr, the number of non-functional ambulators increased from 8 hips before hip fracture to 19 hips at final post-fracture follow-up. These individuals showed poor recovery of ambulatory ability, and the number who died within one year was 11 (23.9%), a rate not significantly different from that among community-dwelling individuals. It was evident that hip-joint-fracture nursing home residents survived for similar periods of time as did those dwelling in the community, though under much more uncomfortable conditions. The main highlight of this report is that it is the first from Korea on nursing home residents' ambulatory recovery and one-year mortality after hip fracture. The authors believe that, beginning with the present study, the government should collect and evaluate the number of hips fractured at nursing facilities in order to formulate criteria that will help to enable all patients to select safer and better-quality nursing facilities for themselves or their family members.

The relationship between preoperative American Society of Anesthesiologists Physical Status Classification scores and functional recovery following hip-fracture surgery

“…Our results demonstrated higher preoperative ASA scores correlated with higher hospital readmissions at 6- and 12-months following hospital discharge, which is consistent with previous reports showing higher preoperative ASA scores are associated with more hospital readmissions [ 9 , 10 ] and poorer ambulatory recovery [ 10 , 24 ]. Our findings showed participants with ASA scores of 3 had significantly poorer recovery of walking ability at 1-and 3-months after discharge.…”

Midterm outcome analysis of bipolar hemiarthroplasty for unstable intertrochanteric femur fractures: A retrospective study

“…In Group B, 43 patients survived for at least five years after intertrochanteric fracture, while the capacity for activity was maintained at final follow-up in 21, declined by one level in 13 patients, and declined by two levels in nine patients (p = 0.051), approaching an acceptable significance level ( Fig. 1) [11]. Postoperatively, there was no significant difference in the HHS for both groups until 36 months.…”

“…The degree of capacity for activity at each follow-up was classified into three levels. Level 1 was defined by cases, where the patient could perform activities alone or use walking-assistance tools (cane, walker) without being helped by others (independent ambulator); level 2 were cases where the patient could perform activities only when helped by others (dependent ambulator); level 3 cases were those in which the patient could not conduct any activities other than moving in a wheelchair or resting in bed (nonfunctional ambulator) [11]. In addition, we compared full weight bearing ambulation between Groups A and B, where possible.…”

One-year Survival Rates and Functional Recovery in Veterans Who Suffer from Hip Fractures: Evaluation of Commissioned Hospitals' System through Comparison between Veterans Hospitals and Commissioned Hospitals

“…The VH group had no co-payment and the CH group had a co-payment for arbitrary uninsured materials and others. Patient capacity for activity before the hip fracture was classified as either: level 1, independent ambulator (patient able to perform activities alone or with walking-assistance tools such as cane and walker); level 2, dependent ambulator (patient required assistance from another individual to perform activities); and level 3, non-functional ambulator (patient incapable of activities other than moving in a wheelchair or resting in bed) 12) . The capacity for activity and death were evaluated retrospectively using hospital records, nursing home records, and phone calls to patients or their lineal family members.…”