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Cumulated ambulation score as predictor of postoperative mobility in patients with proximal femur fractures

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The cumulated ambulation score (CAS) has been developed as an index for evaluating mobility in the early postoperative period. This study aimed to estimate the association between CAS and independent ambulation after surgery for proximal femur fractures.

Materials and methods

This retrospective cohort study included 223 elderly patients who underwent surgery for proximal femur fractures and had independent ambulation before the injury. Multivariable logistic regression analyses with cognitive impairment, pre-injury Barthel index, and CAS as the test variables were used to predict independent ambulation at 2 weeks (model 1) and 3 months (model 2) postoperatively. We established scoring systems based on the modeling results.

Results

The number of patients with independent ambulation at 2 weeks and 3 months postoperatively was 115 and 169, respectively. Univariate analysis showed that the CAS was significantly associated with independent ambulation at 2 weeks and 3 months postoperatively. Multivariable analysis showed that models 1 and 2 had good predictive accuracies, with areas under the receiver-operating characteristic curve of 0.855 and 0.868, respectively. Among the explanatory variables, only the CAS in model 2 was not significantly associated with the postoperative ambulatory ability. Scoring systems for both models 1 and 2 also had good predictive accuracies, with cut-off scores of 3.5 for model 1 and 9.5 for model 2.

Conclusions

The CAS predicted independent ambulation at 2 weeks postoperatively; however, this relationship was limited at 3 months postoperatively. Therefore, the CAS may help estimate independent ambulation at discharge from an acute-care hospital.

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Acknowledgements

We thank Yasukazu Hijikata (MD, MPH) and Takahiro Imaizumi (MD, PhD) for providing detailed information on the analysis.

Funding

The English editing fee was supported by the Systematic Review Workshop Peer Support Group (not for profit organization). The funders played no role in the design of the study and collection, analysis, and interpretation of data, or in writing the manuscript.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Kagawa Prefectural Central Hospital, 1-2-1, Asahi-machi, Takamatsu, Kagawa, 760-8557, Japan

    Norio Yamamoto & Keisuke Kawasaki

  2. Systematic Review Workshop Peer Support Group (SRWS-PSG), Chuo-ku, Osaka, Japan

    Norio Yamamoto

  3. Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Gunma, Japan

    Yosuke Tomita

  4. Department of Physical Therapy, Kagawa Prefectural Central Hospital, Kagawa, Japan

    Arisa Ichinose

  5. Department of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa, Japan

    Shintaro Sukegawa

  6. Department of Physical Therapy, Kyoto Tachibana University, Kyoto, Japan

    Shigeki Yokoyama

  7. Department of Musculoskeletal Traumatology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan

    Tomoyuki Noda

  8. Department of Orthopaedic Surgery, Dentistry and Pharmaceutical Science, Okayama University Graduate School of Medicine, Okayama, Japan

    Toshifumi Ozaki

Authors
  1. Norio Yamamoto
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  2. Yosuke Tomita
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  5. Shigeki Yokoyama
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  6. Tomoyuki Noda
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  7. Keisuke Kawasaki
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  8. Toshifumi Ozaki
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Contributions

All authors contributed to the study conception and design. Data collection was performed by AI and NY. NY conducted statistical analysis. The first draft of the manuscript was written by NY and YT. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Norio Yamamoto.

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Conflict of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Ethical approval

The study protocol was approved by the Ethics Committee (Approval No. 999).

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Informed consent was obtained from all individual participants included in the study.

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Yamamoto, N., Tomita, Y., Ichinose, A. et al. Cumulated ambulation score as predictor of postoperative mobility in patients with proximal femur fractures. Arch Orthop Trauma Surg 143, 1931–1937 (2023). https://doi.org/10.1007/s00402-022-04401-9

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  • DOI: https://doi.org/10.1007/s00402-022-04401-9

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