Background Hip fractures may reduce older people’s chances of remaining independent. The study objective was to describe determinants of recovery of physical functioning after hip fracture in older people.
Methods A prospective study was conducted on patients who sustained hip fracture, operated on at the tertiary hospital in Gorzow, Poland. Physical function was assessed by a questionnaire at baseline, 3 and 6 months thereafter. Sum scores were computed for basic (ADLs) and instrumental activities of daily living (IADLs). A higher score indicated more difficulty.
Results Among 120 patents who were qualified to participate (81.7% females, mean age 82 years), 80.0% reported walking independently 6 months after the operation compared to 100.0% pre-fracture, 2 (1.7%) had died. The mean ADL and IADL scores before discharge were higher compared to measured 6 months after the operation (5.7 vs 4.8; p < 0.001 and 18.5 vs 16.0; p < 0.001). Pre-injury (mean) levels of basic physical functioning were not regained in 46.2% of the patients and instrumental activities of daily living – in 81.1%. The multilevel regression analysis revealed that older age (OR 1.16; p = 0.01), co-morbidities (OR 1.64; p = 0.04) assessed by Charlson Co-morbidity Index, and poor cognitive status (OR 1.83; p < 0.0001) assessed by short portable mental status questionnaire were each associated with lack of recovery in basic physical functions. Gender, residency, the type of hip fracture, time between the injury and admission, the type and duration of surgery, amount of blood loss, and the type of rehabilitation program did not influence ADLs and IADLs.
Conclusions For many older people, long-term functional limitations persist after a hip fracture despite surgery. These findings also demonstrate the importance of personal factors as determinants of recovery from hip fracture and support the need to maintain the good health status of patients before hip surgery through the tailored interventions tackling seniors.
- hip fracture
- physical functioning
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