Prediction of Ambulatory Status After Hip Fracture Surgery in Patients Over 60 Years Old

Ann Rehabil Med. 2016 Aug;40(4):666-74. doi: 10.5535/arm.2016.40.4.666. Epub 2016 Aug 24.

Abstract

Objective: To predict ambulatory capacity, 1 month after physical therapy following hip fracture surgery.

Methods: A retrospective chart review was carried out. Patients more than 60 years old, who underwent hip fracture surgery and received physical therapies, were selected (n=548). Age, gender, presence of cognitive dysfunction, combined medical diseases, combined fractures, previous history of hip surgery, prefracture ambulatory capacity, days from the fracture to surgery, type of fracture, type of surgery, presence of postoperative complications, days from the surgery to physical therapy, and total admission period, were collected. Prefracture ambulatory capacity and postoperative ambulatory capacity were classified into non-ambulatory status (NA), ambulation with assistive device (AA), and independent-ambulation without any assistive device (IA). Multiple-logistic regression analysis was performed for the prediction of postoperative ambulatory capacity.

Results: Age (odds ratio [OR]=0.94 for IA and 0.96 for IA or AA), gender (OR=1.64 for IA and 0.98 for IA or AA), prefracture ambulatory capacity (OR of IA=19.17 for IA; OR of IA=16.72 for IA or AA; OR of AA=1.26 for IA, OR of AA=9.46 for IA or AA), and combined medical disease (OR=2.02) were found to be the factors related to postoperative ambulatory capacity and the prediction model was set up using these four factors.

Conclusion: Using this model, we can predict the ambulatory capacity following hip fracture surgery. Further prospective studies should be constructed to improve postoperative ambulatory capacity.

Keywords: Aged; Dependent ambulation; Hip fractures; Prognosis; Surgery; Walking.