Ann Rehabil Med.  2016 Aug;40(4):666-674. 10.5535/arm.2016.40.4.666.

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

• Kim JL
• Jung JS
• Kim SJ

• KMID: 2356652
• DOI: http://doi.org/10.5535/arm.2016.40.4.666

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.

Keyword

Hip fractures; Walking; Dependent ambulation; Prognosis; Aged; Surgery

MeSH Terms

Dependent Ambulation
Hip Fractures
Hip*
Humans
Postoperative Complications
Prognosis
Prospective Studies
Retrospective Studies
Self-Help Devices
Walking

Figure

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  Fig. 1 (A) Distribution of age, (B) total admission period, (C) days from the fracture to surgery, and (D) days from the surgery to rehabilitation, according to the postoperative ambulatory capacity presented. The boxes are averages and the lines are one standard deviation. NA, non-ambulatory status; AA, ambulation with assistive device; IA, independent-ambulation without device.

• 

  Fig. 2 Proportions of postoperative ambulatory capacity are presented according to the prefracture ambulatory capacity, gender, and presence of combined medical disease. (A) Prefracture ambulatory capacity is "NA", (B) prefracture ambulatory capacity is "IA", (C) prefracture ambulatory capacity is "AA". NA, non-ambulatory status; AA, ambulation with assistive device; IA, independent-ambulation without device; 1, Man, no combined medical disease; 2, Man, combined medical disease; 3, Woman, no combined medical disease; 4, Woman, combined medical disease.

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  Fig. 3 The equation of the prediction model. NA, non-ambulatory status; AA, ambulation with assistive device; IA, independent-ambulation without device.

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  Fig. 4 Probability of postoperative ambulatory status in several cases. IA, independent-ambulation without device, AA, ambulation with assistive device; NA, non-ambulatory status.

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