Patient, surgical and hospital factors predicting actual first-day mobilisation after hip fracture surgery: An observational cohort study

Victoria Woodcroft-Brown; Jack Bell; Chrysanth Ranjeev Pulle; Rebecca Mitchell; Jacqueline Close; Catherine McDougall; Sarah Hurring; Mitchell Sarkies

doi:10.1111/ajag.13312

Patient, surgical and hospital factors predicting actual first-day mobilisation after hip fracture surgery: An observational cohort study

Australas J Ageing. 2024 Apr 14. doi: 10.1111/ajag.13312. Online ahead of print.

Authors

Victoria Woodcroft-Brown¹, Jack Bell², Chrysanth Ranjeev Pulle¹, Rebecca Mitchell³, Jacqueline Close^{4

5}, Catherine McDougall^{1

6}, Sarah Hurring⁷, Mitchell Sarkies^{3

8

9}

Affiliations

¹ The Prince Charles Hospital, Metro North Hospital and Health Service, Brisbane, Queensland, Australia.
² The Prince Charles Hospital Allied Health Research Collaborative (AHRC), The Prince Charles Hospital, Brisbane, Queensland, Australia.
³ Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia.
⁴ Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, New South Wales, Australia.
⁵ School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia.
⁶ School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
⁷ Older Person's Health Specialist Service, Te Whatu Ora Waitaha, Canterbury, New Zealand.
⁸ Sydney School of Health Services, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
⁹ Implementation Science Academy, Sydney Health Partners, Sydney, New South Wales, Australia.

PMID: 38616338
DOI: 10.1111/ajag.13312

Abstract

Objectives: To examine patient, surgical and hospital factors associated with Day-1 postoperative mobility after hip fracture surgery in older adults.

Methods: A cohort study using Australia and New Zealand Hip Fracture Registry was conducted. Participants were aged older than 50 years and underwent hip fracture surgery between 1 January 2020 and 31 December 2020 inclusive. The outcome was standing and step transferring out of bed onto a chair and/or walking Day-1 after hip fracture surgery.

Results: Mean age was 82 years and 68% were women. Of 12,318 patients with hip fracture, 5981 (49%) actually mobilised Day-1. Odds of actual first-day mobilisation were lower for individuals usually walking with either stick or crutch (OR = 0.71, 95% CI 0.62-0.82) or two aids or frame (OR = 0.57, 95% CI 0.52-0.64) or wheelchair/bed bound (OR = 0.24, 95% CI 0.17-0.33); who had impaired cognition preadmission (OR = 0.57, 95% CI 0.51-0.64); from aged care facilities (OR = 0.59, 95% CI 0.52-0.67); had an American Society of Anaesthesiologists grade 2 (OR = 0.63, 95% CI 0.41-0.97), 3 (OR = 0.31, 95% CI 0.20-0.47) or 4 or 5 (OR = 0.21, 95% CI 0.14-0.32); surgery delay >48 h (OR = 0.81, 95% CI 0.71-0.91); and restricted/non-weight-bearing status immediately postoperatively (OR = 0.53, 95% CI 0.42-0.67).

Conclusions: Both non-modifiable and modifiable patient and surgical factors influence first-day mobilisation after hip fracture surgery. Reducing time to surgery might assist future quality improvement efforts to increase Day-1 postoperative mobility.

Keywords: early ambulation; hip fractures; orthopedic procedures; osteoporotic fractures; physical therapy specialty.

Grants and funding

2007970/National Health and Medical Research Council