Highlights
- •Hip fracture is associated with a high risk of disability and death.
- •Factors associated with mortality are age, functional loss and cognitive impairment.
- •Living alone increases by three, the risk of institutionalization.
- •In this single centre, observational study, the rehabilitation improves functional recovery and reduces mortality.
Abstract
Objective
To identify the factors associated to institutionalization and mortality in elderly
patients with hip fractures (HF).
Design
Thirty-six months observational study.
Setting
A post-acute rehabilitation ward.
Participants
subjects living in the community or in nursing-home, above the age of 65, with HF.
Measurements
The following were registered: comorbidity, intra-hospital complications, Barthel
index, walking ability and Mini Mental State Examination, as well as blood samples
upon admission and discharge. Destination upon discharge was recorded as well as mortality
during hospital stay and over the three-year follow up.
Results
a total of 430 subjects were included in the study. Twenty-three patients (5.3%) died
during their stay in hospital and 152 (35.3%) during follow up after discharge. Forty-five
patients (10.5%) were institutionalized upon discharge. In adjusted analysis, the
factors that predict intra-hospital mortality are higher comorbidity (OR, 1.46; 95%CI,
1.06–2.01), and the number of complications (OR, 1.71; 95%CI, 1.16–2.64).
Factors that predict mortality in the long term are age (HR 1.04; 95%CI, 1.01–1.06),
comorbidity (HR 1.19, 95% CI, 1.09–1.30), the number of complications (HR 1.17, 95%CI,
1.05–1.31).
The factors that predicted new institutionalization were age (OR 1.04, 95%CI, 0.98–1.09),
living alone (OR 3.95, 95%CI, 1.38–11.3), and length of hospital stay (OR 1.02 95%CI,
1.00–1.03).
Conclusions
Mortality 3 years after a hip fracture and institutionalization are associated to
age, the loss of autonomy in walking, a worse cognitive status and living alone before
the fracture. Identification of and, when possible, intervention upon these factors
can improve care of elderly people with hip fractures.
Keywords
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Article info
Publication history
Published online: April 08, 2016
Accepted:
April 7,
2016
Received in revised form:
April 6,
2016
Received:
February 3,
2016
Identification
Copyright
© 2016 Elsevier Ireland Ltd. All rights reserved.
