Predictors of a Change and Correlation in Activities of Daily Living after Hip Fracture in Elderly Patients in a Community Hospital in Poland: A Six-Month Prospective Cohort Study
Abstract
:1. Introduction
2. Objectives
3. Materials and Methods
3.1. Design, Setting, Population, and Sampling
3.2. Data Collection
3.3. Statistical Analysis
4. Results
4.1. Baseline Characteristics and Surgical Features of Patients
4.2. Change in Functional Status
4.3. Prognostic Factors for Functional Status at Follow-Up
4.4. Correlation between ADL and IADL
5. Discussion
5.1. Results Overview
5.2. Change in Functional Status
5.3. Correlation between ADL and IADL
5.4. Predictors for Functional Outcomes: ADL and IADL
6. Limitations
7. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Variable | Total | SPMSQ 8–10 | SPMSQ 6–7 | SPMSQ 3–5 | p |
---|---|---|---|---|---|
N = 120 | N = 59 | N = 29 | N = 32 | ||
Age (years) | |||||
Mean | 80.1 | 79.6 | 83.3 | 82 | 0.002 * |
Gender | |||||
Female | 98 (81.7) | 47 (79.7) | 24 (82.8) | 27 (84.3) | 0.84 * |
Male | 22 (18.3) | 12 (20.3) | 5 (17.2) | 5 (15.7) | |
Residence | |||||
Urban | 74 (61.7) | 37 (62.7) | 20 (69.0) | 16 (50.0) | 0.29 * |
Rural | 46 (38.3) | 22 (37.2) | 9 (31.0) | 16 (50.0) | |
CCI Index | |||||
1–3 | 60 (50.0) | 41 (69.5) | 13 (44.8) | 6 (18.8) | <0.001 ** |
4–7 | 60 (50.0) | 18 (30.5) | 16 (55.2) | 26 (81.2) | Tau −0.43 |
ADL index | |||||
5–6 | 110 (91.7) | 58 (98.3) | 29 (100.0) | 23 (71.9) | <0.001 ** |
3–4 | 8 (6.7) | 1 (1.7) | 0 (0.0) | 7 (21.9) | Tau 0.35 |
0–2 | 2 (1.6) | 0 (0.0) | 0 (0.0) | 2 (6.2) | |
IADL score | |||||
19–24 | 65 (54.2) | 54 (91.5) | 10 (34.5) | 1 (3.1) | <0.001 ** |
13–18 | 36 (30.0) | 4 (6.8) | 19 (65.5) | 13 (40.6) | Tau 0.77 |
9–12 | 13 (10.8) | 1 (1.7) | 0 (0.0) | 12 (37.5) | |
≤8 | 6 (5.0) | 0 (0.0) | 0 (0.0) | 6 (18.8) | |
Type of fracture | |||||
Intertrochanteric | 75 (62.5) | 38 (64.4) | 18 (62.1) | 20 (62.5) | 0.97 * |
Femoral neck | 44 (37.5) | 21(35.6) | 11 (37.9) | 12 (37.5) | |
Time to surgery | |||||
≤48 h | 72 (51.7) | 21 (35.6) | 15 (51.7) | 12 (37.5) | 0.32 * |
>48 h | 48 (48.3) | 38 (64.4) | 14 (48.3) | 20 (62.5) | |
Type of anesthesia | |||||
Local | 107 (89.2) | 55 (93.2) | 26 (89.7) | 26 (81.3) | 0.20 * |
General | 13 (10.8) | 4 (6.8) | 3 (10.3) | 6 (18.7) | |
ASA class | |||||
1–2 | 47 (39.1) | 31 (52.5) | 10 (34.5) | 6 (18.7) | 0.001 ** |
3–4 | 73 (60.9) | 28 (47.5) | 19 (65.5) | 26 (81.3) | Tau 0.27 |
Type of procedure | |||||
Osteosynthesis | 79 (65.8) | 42 (71.2) | 18 (62.1) | 19 (59.4) | 0.46 * |
Arthroplasty | 41 (34.2) | 17 (28.8) | 11 (37.9) | 13 (40.6) | |
Blood transfusion | |||||
Yes | 31 (25.8) | 10 (16.9) | 9 (31.0) | 12 (37.5) | 0.07 * |
No | 89 (74.2) | 49 (80.1) | 20 (69.0) | 20 (62.5) | |
Mean length of surgery (min) | |||||
59.4 | 58.2 | 62.9 | 61.6 | 0.49 ** | |
Mean length of hospital stay (days) | |||||
14.1 | 15.2 | 13.2 | 12.8 | 0.54 ** | |
Mean time from surgery to mobilization (days) | |||||
2 | 2.1 | 2.6 | 2.4 | 0.54 ** |
Variable | ADL | IADL | ||||||
---|---|---|---|---|---|---|---|---|
3 Months | 6 Months | 3 Months | 6 Months | |||||
OR | 95% CI | OR | 95% CI | OR | 95% CI | OR | 95% CI | |
Gender | ||||||||
Male | 1 | 1 | 1 | 1 | ||||
Female | 5.79 | 1.35–24.88 * | 2.11 | 0.55–8.04 | 1.96 | 0.36–10.62 | 1.03 | 0.35–3.06 |
Age | ||||||||
≥80 years | 1 | 1 | 1 | 1 | ||||
<80 years | 2.23 | 0.68–7.05 | 1.23 | 0.40–1.24 | 1.11 | 0.31–3.97 | 4.11 | 1.47–11.48 ** |
SPMSQ index: | ||||||||
Cognitive impairment | 1 | 1 | 1 | 1 | ||||
Intact intellectual functioning | 11.67 | 3.13–23.54 *** | 7.2 | 2.19–22.84 *** | 7.19 | 1.09–27.40 * | 1.2 | 0.48–3.13 |
Pre-fracture ADL index | 1.13 | 0.63–2.02 | 1.23 | 1.02–3.17 * | ||||
Pre-fracture IADL score | - | - | - | - | 4 | 1.62–9.73 ** | 1.17 | 1.03–1.40 * |
R2 | 0.376 | 0.374 | 0.189 | 0.165 |
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Ganczak, M.; Chrobrowski, K.; Korzeń, M. Predictors of a Change and Correlation in Activities of Daily Living after Hip Fracture in Elderly Patients in a Community Hospital in Poland: A Six-Month Prospective Cohort Study. Int. J. Environ. Res. Public Health 2018, 15, 95. https://doi.org/10.3390/ijerph15010095
Ganczak M, Chrobrowski K, Korzeń M. Predictors of a Change and Correlation in Activities of Daily Living after Hip Fracture in Elderly Patients in a Community Hospital in Poland: A Six-Month Prospective Cohort Study. International Journal of Environmental Research and Public Health. 2018; 15(1):95. https://doi.org/10.3390/ijerph15010095
Chicago/Turabian StyleGanczak, Maria, Krzysztof Chrobrowski, and Marcin Korzeń. 2018. "Predictors of a Change and Correlation in Activities of Daily Living after Hip Fracture in Elderly Patients in a Community Hospital in Poland: A Six-Month Prospective Cohort Study" International Journal of Environmental Research and Public Health 15, no. 1: 95. https://doi.org/10.3390/ijerph15010095