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What are the influencing factors in self-rated health status after hip fracture? A prospective study on 402 patients

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Abstract

Summary

Health status (HS) and influencing factors in HS were evaluated six and 12 months after hip fracture. One-third of the patients did not reach their pre-fracture HS within 1 year. HS before fracture and fall risk could, inter alia, be identified as influencing factors.

Purpose

From a patient’s perspective, regaining pre-fracture health status (HS) is one of the most important factors concerning the outcome after hip fracture. The aim of this study was to evaluate the HS and particularly to identify influencing factors in HS 6 and 12 months after hip fracture.

Methods

A total of 402 patients with hip fractures aged 60 years and older were included. HS was evaluated using the EQ-5D questionnaire pre-fracture and at 6 and 12 months after surgery. Multivariate regression analysis was performed to identify influencing factors in HS at 6 and 12 months. Afterwards, the results in the EQ-5D index were dichotomized into worse and equal/better results than before fracture, and a multivariate logistic regression analysis was performed for the dichotomized variables at 6 and 12 months.

Results

The EQ-5D index decreased from 0.71 before the fracture to 0.60 at 6 months (p < 0.001) and increased slightly to 0.63 at 12 months (p = 0.328). A high pre-fracture EQ-5D index was associated with not reaching the pre-fracture EQ-5D index, and a high Tinetti score at hospital discharge was associated with reaching the pre-fracture EQ-5D index at 6 and 12 months. A high ASA score was an influencing factor behind a lower EQ-5D index than before the fracture at 6 months.

Conclusions

Hip fractures constitute a deep and long-lasting drop in the patients’ HS. Early and intensive physiotherapy and individualized rehabilitation programmes regarding a patient’s living situation before the fracture seem to be essential to improve HS.

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Authors and Affiliations

  1. Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Marburg, Germany

    Juliana Hack, Benjamin Buecking, Rene Aigner, Ludwig Oberkircher, Tom Knauf, Steffen Ruchholtz & Daphne Eschbach

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  1. Juliana Hack
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  2. Benjamin Buecking
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  3. Rene Aigner
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Correspondence to Juliana Hack.

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Institutional review board approval was obtained from the ethics committee (AZ 175/08). All of the patients provided written informed consent for participation in the study.

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Hack, J., Buecking, B., Aigner, R. et al. What are the influencing factors in self-rated health status after hip fracture? A prospective study on 402 patients. Arch Osteoporos 14, 92 (2019). https://doi.org/10.1007/s11657-019-0642-x

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