Which factors are independent predictors of early recovery of mobility in the older adults’ population after hip fracture? A cohort prognostic study
- 1.1k Downloads
The aim of the present study was to identify all factors that might influence the short-term recovery of mobility in older adults’ patients after hip surgery.
A prospective cohort prognostic study was carried out. The study enrolled all consecutive patients aged 65 years or over admitted for hip fracture due to fragility. Patients were monitored from their admission into the emergency department of the hospital, until their discharge. The level of mobility was measured by the ILOA scale, administered during the 6th day of hospitalisation. The identified variables were divided into baseline patient variables, linked to the patient’s characteristics, and, healthcare/hospital variables, linked to the program of care within post-surgery hospitalisation.
The total number of patients enrolled and examined at discharge was 484. Six days after surgery, the level of mobility achieved by patients, as measured by ILOA Scale, was 42.4 (± 6.0). Increased age (B = 0.111; p = 0,042), pressure sore mattress with a motor used (B = 3.817; p < 0.0005), delay in achieving an upright position (B = 0.509; p < 0.0005), no recovery of walking (b = 2.339; p < 0.0005), prolonged use of diapers (B = 0.004; p < 0.0005) or catheter (B = 0.089; p < 0.0005), indication for no weight bearing (B = 2.023; p = 0.031), and temperature for fewer days (B = 0.040; p = 0.023) are factors able to affect negatively recovery of mobility in the initial post-operative period in patients surgically treated for hip fracture.
Therapy and physiotherapy choices after surgery for hip fracture are significantly associated with early recovery of mobility of older adults’ patients, regardless of their baseline conditions. Early removal of supporting devices promoting prolonged bed immobility, such as air mattress, catheter, and incontinence pad, together with achieving an early upright position, are elements to take into account when planning future trials to understand its efficacy in enabling better recovery of mobility.
KeywordsHip fracture Early ambulation Rehabilitation Nursing care Postoperative care
Compliance with ethical standards
Ethics committee approval
All procedures performed in studies involving human participants were in accordance with the ethics standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethics standards.
Informed consent was obtained from all individual participants included in the study.
Conflict of interest
The authors declare that they have no potential conflict of interest.
- 1.Marks R (2010) Hip fracture epidemiological trends, outcomes, and risk factors, 1970-2009. Int J Gen Med 8(3):1–17Google Scholar
- 5.Scottish Intercollegiate Guideline Network (SIGN). Management of hip fracture in older people. A national guideline. http://www.sign.ac.uk/guidelines/fulltext/111/. Accessed 10 May 2017
- 6.National Insitute for Health and Care Excellence. Hip fracture: management. www.nice.org.uk/guidance/cg124. Accessed 10 May 2017
- 13.Tarazona-Santabalbina FJ, Belenguer-Varea Á, Rovira Daudi E, Salcedo Mahiques E, Cuesta Peredó D, Doménech-Pascual JR et al (2015) Severity of cognitive impairment as a prognostic factor for mortality and functional recovery of geriatric patients with hip fracture. Geriatr Gerontol Int 15(3):289–295CrossRefPubMedGoogle Scholar
- 14.Buecking B, Bohl K, Eschbach D, Bliemel C, Aigner R, Balzer-Geldsetzer M et al (2015) Factors influencing the progress of mobilization in hip fracture patients during the early postsurgical period?-A prospective observational study. Arch Gerontol Geriatr 60(3):457–463. doi: 10.1016/j.archger.2015.01.017 CrossRefPubMedGoogle Scholar
- 16.Bellelli G, Noale M, Guerini F, Turco R, Maggi S, Crepaldi G et al (2012) A prognostic model predicting recovery of walking independence of elderly patients after hip-fracture surgery. An experiment in a rehabilitation unit in Northern Italy. Osteoporos Int 23(8):2189–2200CrossRefPubMedGoogle Scholar
- 20.Barone A, Giusti A, Pizzonia M, Razzano M, Oliveri M, Palummeri E et al (2009) Factors associated with an immediate weight-bearing and early ambulation program for older adults after hip fracture repair. Arch Phys Med Rehabil 90(9):1495–1498. doi: 10.1016/j.apmr.2009.03.013 CrossRefPubMedGoogle Scholar