Factors Associated With Ambulation Status and Survival One Year After Conservative Management of Hip Fracture

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2024 Aug 12

PMID 39131017

Authors

Keisuke Nakamura

Tomohiro Sasaki

Marin Yokoyama

Takashi Kitagawa

Yuto Akashi

Masayuki Shimizu

Affiliations

Soon will be listed here.

Abstract

Purpose: Few studies have investigated the factors associated with ambulation and survival over one year. Therefore, this study aimed to examine the factors that influence ambulation and survival rates in elderly patients who have undergone conservative management for hip fractures.

Materials And Methods: This retrospective study included 74 ambulatory individuals aged 65 years or older prior to their injuries. One-year mortality and ambulatory status were assessed. Statistical comparisons of background and medical characteristics between groups of independent and non-independent walkers, as well as between survivors and mortalities, were performed using the Pearson chi-squared, Fisher exact, and Mann-Whitney U tests.

Results: The numbers of older patients able to walk independently, those not able to walk independently, and those with mortality at one-year post-injury after conservative management of hip fractures were 13 (18.3%), 35 (49.3%), and 23 (32.4%), respectively. Independent walkers one year after conservative treatment for hip fracture were younger (p=0.04) and less likely to have cognitive impairment (p=0.04) than non-independent walkers. The proportion of individuals with cognitive impairment was found to be lower among survivors than among mortalities (p=0.0098).

Conclusion: Cognitive decline may contribute to difficulties in walking independently and mortality at one year post-injury in this population.

References

Yoon B, Baek J, Kim M, Lee Y, Ha Y, Koo K . Poor prognosis in elderly patients who refused surgery because of economic burden and medical problem after hip fracture. J Korean Med Sci. 2013; 28(9):1378-81. PMC: 3763115. DOI: 10.3346/jkms.2013.28.9.1378. View

Moulton L, Green N, Sudahar T, Makwana N, Whittaker J . Outcome after conservatively managed intracapsular fractures of the femoral neck. Ann R Coll Surg Engl. 2015; 97(4):279-82. PMC: 4473865. DOI: 10.1308/003588415X14181254788809. View

Chow S, Qin J, Wong R, Yuen W, Ngai W, Tang N . One-year mortality in displaced intracapsular hip fractures and associated risk: a report of Chinese-based fragility fracture registry. J Orthop Surg Res. 2018; 13(1):235. PMC: 6137732. DOI: 10.1186/s13018-018-0936-5. View

Amrayev S, AbuJazar U, Stucinskas J, Smailys A, Tarasevicius S . Outcomes and mortality after hip fractures treated in Kazakhstan. Hip Int. 2018; 28(2):205-209. DOI: 10.1177/1120700018773395. View

Gong Q, Ishii M, Numata O, Xie W, Hirata T . Utility of a shortened Hasegawa Dementia Scale Revised questionnaire to rapidly screen and diagnose Alzheimer's disease. Aging Med (Milton). 2021; 4(2):109-114. PMC: 8251873. DOI: 10.1002/agm2.12152. View

Lim W, Kwek E . Outcomes of an accelerated nonsurgical management protocol for hip fractures in the elderly. J Orthop Surg (Hong Kong). 2018; 26(3):2309499018803408. DOI: 10.1177/2309499018803408. View

Yoshitaka T, Shimaoka Y, Yamanaka I, Tanida A, Tanimoto J, Toda N . Cognitive Impairment as the Principal Factor Correlated with the Activities of Daily Living Following Hip Fracture in Elderly People. Prog Rehabil Med. 2022; 7:20220026. PMC: 9110876. DOI: 10.2490/prm.20220026. View

Frenkel Rutenberg T, Assaly A, Vitenberg M, Shemesh S, Burg A, Haviv B . Outcome of non-surgical treatment of proximal femur fractures in the fragile elderly population. Injury. 2019; 50(7):1347-1352. DOI: 10.1016/j.injury.2019.05.022. View

von Elm E, Altman D, Egger M, Pocock S, Gotzsche P, Vandenbroucke J . The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008; 61(4):344-9. DOI: 10.1016/j.jclinepi.2007.11.008. View

10.

Feng J, Zhang C, Li B, Zhan S, Wang S, Song C . Global burden of hip fracture: The Global Burden of Disease Study. Osteoporos Int. 2023; 35(1):41-52. DOI: 10.1007/s00198-023-06907-3. View

11.

Hagino H, Osaki M, Okuda R, Enokida S, Nagashima H . Recent trends in the incidence of hip fracture in Tottori Prefecture, Japan: changes over 32 years. Arch Osteoporos. 2020; 15(1):152. PMC: 7529614. DOI: 10.1007/s11657-020-00823-3. View

12.

Loggers S, Van Lieshout E, Joosse P, Verhofstad M, Willems H . Prognosis of nonoperative treatment in elderly patients with a hip fracture: A systematic review and meta-analysis. Injury. 2020; 51(11):2407-2413. DOI: 10.1016/j.injury.2020.08.027. View

13.

Prommik P, Kolk H, Sarap P, Puuorg E, Harak E, Kukner A . Estonian hip fracture data from 2009 to 2017: high rates of non-operative management and high 1-year mortality. Acta Orthop. 2019; 90(2):159-164. PMC: 6461069. DOI: 10.1080/17453674.2018.1562816. View

14.

Berry S, Rothbaum R, Kiel D, Lee Y, Mitchell S . Association of Clinical Outcomes With Surgical Repair of Hip Fracture vs Nonsurgical Management in Nursing Home Residents With Advanced Dementia. JAMA Intern Med. 2018; 178(6):774-780. PMC: 5997966. DOI: 10.1001/jamainternmed.2018.0743. View

15.

Gregory J, Kostakopoulou K, Cool W, Ford D . One-year outcome for elderly patients with displaced intracapsular fractures of the femoral neck managed non-operatively. Injury. 2010; 41(12):1273-6. DOI: 10.1016/j.injury.2010.06.009. View

16.

Rashidifard C, Romeo N, Muccino P, Richardson M, DiPasquale T . Palliative Management of Nonoperative Femoral Neck Fractures With Continuous Peripheral Pain Catheters: 20 Patient Case Series. Geriatr Orthop Surg Rehabil. 2017; 8(1):34-38. PMC: 5315249. DOI: 10.1177/2151458516683226. View

17.

Takusari E, Sakata K, Hashimoto T, Fukushima Y, Nakamura T, Orimo H . Trends in Hip Fracture Incidence in Japan: Estimates Based on Nationwide Hip Fracture Surveys From 1992 to 2017. JBMR Plus. 2021; 5(2):e10428. PMC: 7872333. DOI: 10.1002/jbm4.10428. View

18.

Chlebeck J, Birch C, Blankstein M, Kristiansen T, Bartlett C, Schottel P . Nonoperative Geriatric Hip Fracture Treatment Is Associated With Increased Mortality: A Matched Cohort Study. J Orthop Trauma. 2019; 33(7):346-350. DOI: 10.1097/BOT.0000000000001460. View

19.

Hamilton B, Laughlin J, Fiedler R, Granger C . Interrater reliability of the 7-level functional independence measure (FIM). Scand J Rehabil Med. 1994; 26(3):115-9. View

20.

Ioannidis I, Mohammad Ismail A, Forssten M, Ahl R, Cao Y, Borg T . The mortality burden in patients with hip fractures and dementia. Eur J Trauma Emerg Surg. 2021; 48(4):2919-2925. PMC: 9360069. DOI: 10.1007/s00068-021-01612-4. View