PAPER 32: PREDICTORS OF FUNCTIONAL OUTCOME FOLLOWING HIP FRACTURE IN MOBILE, INDEPENDENT, ELDERLY PATIENT. A SIX MONTHS PROSPECTIVE COHORT STUDY

Abstract

Objective: To study potential predictors of functional outcome six months after the injury in elderly patients who sustained a hip fracture and who had been able to go out alone.

Design: Prospective Multi-center Cohort Study

Setting: 14 Hospitals in Japan

Patients and Methods: A cohort was consisted of 387 patients with a mean age of 81 who had a hip fracture, between December 2004 and January 2006. Inclusion criteria were that patients were at least sixty-five years old and who had been able to go out independently. Level of activity of daily living, medical complications, residential environment and family structure at injury was interviewed from the patient, the relatives and a nursing caretaker and recorded. Advancement of mobility was also recorded during the hospital stay. Patients were contacted or interviewed again by the investigator at six months following injury to assess functional outcomes. Primary outcome of interest was changes in mobility to go out independently at six months after injury.

Results: 178 patients (46%) lost their independency to go out at six month following surgery. Logistic multivariant regression showed that age, cognitive function, hemiplegia and mobile ability at discharge were the independent predictable factors for losing independency of mobility. At hospital discharge, T-cane walk was accomplished in only 53% for looser group but 86% for maintain group.

Conclusions: We believe that it would be the key factor to improve the mobility of the healthy patient with hip fracture that we lead them to T-cane walk before hospital discharge.