Trends in Patient-Reported Physical Function After Hip Fracture Surgery.

Autor:	Rana P; Orthopedic Research, Anne Arundel Medical Center, Annapolis, USA., Brennan JC; Orthopedic Research, Anne Arundel Medical Center, Annapolis, USA., Johnson AH; Orthopedics, Anne Arundel Medical Center, Annapolis, USA., King PJ; Orthopedic Surgery, Anne Arundel Medical Center, Annapolis, USA., Turcotte JJ; Orthopedic and Surgical Research, Anne Arundel Medical Center, Annapolis, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Jul 15; Vol. 16 (7), pp. e64572. Date of Electronic Publication: 2024 Jul 15 (Print Publication: 2024).
DOI:	10.7759/cureus.64572
Abstrakt:	Background Hip fractures carry significant morbidity and mortality, yet studies assessing post-surgical functional recovery from the patient's perspective are scarce, lacking benchmarks against age-matched populations. This study aimed to identify factors influencing postoperative functional outcomes, compared to the lower 25th percentile of normal age-matched populations, and to compare postoperative physical function with one-year mortality following hip fracture surgery. Methodology A retrospective review of 214 hip fracture patients reporting to the emergency department (ED) from July 2020 to June 2023 was conducted, with all completing a three-month postoperative Patient-Reported Outcomes Measurement Information System-Physical Function (PROMIS-PF) survey. Primary outcomes included three-month PROMIS-PF scores, with secondary outcomes focusing on one-year mortality. Factors such as demographics, comorbidities, procedures, time to surgery, length of stay, and postoperative outcomes were analyzed for correlation. Multivariate logistic regression assessed predictors of achieving a PROMIS-PF T-score of at least 32.5, representing the bottom 25th percentile for age-matched populations, and the relationship between three-month PROMIS PF T-scores and one-year mortality. Results Surgery was performed within 24 hours of ED arrival in 118 (55.1%) patients, the average length of stay was 5.2 days, and 64 (29.9%) were discharged home. Total hip arthroplasty and home discharge correlated with higher physical function scores. In contrast, older age, higher American Society of Anesthesiologists scores, certain comorbidities, specific surgical procedures, and longer hospital stays were associated with lower scores. Fewer than half (102 [47.7%]) achieved functional levels comparable to the 25th percentile of age-matched populations. Multivariate analysis indicated chronic obstructive pulmonary disease and home discharge as predictors of achieving this threshold, while higher PROMIS-PF T-scores were associated with reduced one-year mortality. Conclusions Patients undergoing hip fracture surgery are unlikely to achieve high levels of physical function within the three-month postoperative period. Fewer than half of these patients will reach functional levels, and decreased early function is associated with an increased risk of one-year mortality. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: Paul King declare(s) Research support from FirstKind, Ltd. Paul King declare(s) non-financial support from Journal of Arthroplasty. Editorial Board. Paul King declare(s) personal fees from Smith and Nephew. Paid Consultant. Paul King declare(s) Research support from Depuy. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Rana et al.)
Databáze:	MEDLINE
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