Abstract
Objectives
To examine the prognostic value of different profiles of hip fracture patients for recovery of pre-fracture functional level and for post-fracture mortality.
Design
Observational, longitudinal study.
Setting
University hospital.
Participants
Five hundred and eight patients who received surgery for hip fracture and were followed for 24 months post-fracture.
Measuments
Patients were assessed according to age, number of independent activities of daily living (ADLs) and dementia. The probability of recovery of previous ambulation level and mortality was established at 3, 6, 12 and 24 months post-fracture. Patients were first classified according to the seven different profiles previously established by Penrod. A new patient classification system was then created using different patient groups: persons aged 75 or older were first classified based on the number of independent ADLs they could perform (4, 3–2 and 1–0) and were then subdivided according to age (75–84 years and >84 years) and presence of dementia.
Results
Mean age was 84.5 (SD 6.3) years. Almost all (90.6%) patients walked independently before the fracture. At 24 months’ follow-up, the probability of recovery to previous level of ambulation was 73.6%. The new classification into seven groups had higher prognostic value than Penrod’s system. Patients under 75 had 95.1% probability of functional recovery and 9.6% of dying. At the other extreme, those over 84 years with 0–1 independent activities of daily living and dementia had 23.9% probability of recovery and 71.4% of dying.
Conclusion
Hip fracture patients can be classified into homogeneous groups with different prognostic profiles based on pre-fracture characteristics. This new classification improves Penrod’s previous system by establishing groups of patients hierarchically ordered by the probability of recovery and mortality at 3, 6, 12 and 24 months post-fracture.
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Alarcón, T., Gonzalez-Montalvo, J.I., Gotor, P. et al. A new hierarchical classification for prognosis of hip fracture after 2 years’ follow-up. J Nutr Health Aging 15, 919–923 (2011). https://doi.org/10.1007/s12603-011-0129-y
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DOI: https://doi.org/10.1007/s12603-011-0129-y