Predictors of short-term hip fracture rehabilitation outcomes in a tertiary hospital

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Authors: Tan Y Leng, Saw H Mar, Lim Su-Fee, Lee C Lynn, and Ng Y Sien
Page Range: 231-241
Published in: International Journal on Disability and Human Development, Volume 17 Issue 2
ISSN: 2191-1231

ISBN: N/A Category:

Table of Contents

ABSTRACT

Hip fracture patients often spend short periods of time in an acute hospital for rehabilitation. Tertiary hospitals have rehabilitation programs after hip surgery to re-integrate these patients back to community. We conducted a study to identify factors affecting short-term outcomes at the point of hospital discharge. Methods: 121 hip fracture patients with hip surgery were studied during their course of in-patient rehabilitation in Singapore General Hospital (SGH). Our outcome measures included ambulation distance (in metres) at the point of discharge, discharge total Functional Independence Measure (DFIM) and Rehabilitation length-of-stay (RLOS). Results: The mean age was 74.6 ± 9.9 years and 71.1% (n = 86) were female. Seventy-three (60.3%) were neck of femur fractures and the rest were intertrochanteric fractures. The mean ambulation distance achieved was 56.7 ± 54.0 metres. The mean DFIM was 94.2 ± 19.9 and the mean RLOS was 21.0 ± 10.9 days. Younger patients of age < 75 achieved better DFIM (P = 0.013) and shorter RLOS (P = 0.022). Admission FIM > 70 predicts better ambulation distance (P = 0.018), higher DFIM (P < 0.001) and reduced RLOS (P = 0.022). Those who function independently without caregiver achieved better ambulation distance (P = 0.001) and higher DFIM (P = 0.008). Subjects without pre-existing ischemic heart disease achieved better ambulation distance (P = 0.012) and DFIM (P = 0.001) while those without post-operative UTI (P = 0.019) achieved better DFIM. Individuals with NOF fractures achieved better walking distance (P = 0.042) and shorter RLOS (P < 0.001). Conclusion: Identifying predictors affecting short term clinical outcomes after hip surgery is useful in devising better rehabilitation strategies and triaging of appropriate rehabilitation sites for hip fracture patients in a tertiary hospital. Keywords: Hip fracture, surgery, rehabilitation, Singapore

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