Predictors of recovering ambulation after hip fracture inpatient rehabilitation
| Autor: | Manuele Barilli, Claudio Macchi, Francesca Cecchi, Chiara Sarti, Lucilla Landucci Pellegrini, Silvia Pancani, Massimo Gambini, Lucia Avila, Guido Pasquini, Desiderio Antonioli, Emanuela Romano, Margherita Zingoni, Maria Assunta Gabrielli, Federica Vannetti |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
Trunk control medicine.medical_specialty Referral medicine.medical_treatment Comorbidity Walking lcsh:Geriatrics Patient Readmission Rehabilitation Centers Rehabilitation outcome Hip fracture 03 medical and health sciences Predictors of ambulation Aged Aged 80 and over Female Hip Fractures Hospitalization Humans Inpatients Length of Stay Patient Discharge Predictive Value of Tests Recovery of Function Self Care Geriatrics and Gerontology 0302 clinical medicine Acute care medicine Risk of mortality 030212 general & internal medicine Rehabilitation business.industry medicine.disease lcsh:RC952-954.6 Physical therapy business 030217 neurology & neurosurgery Inpatient rehabilitation Research Article |
| Zdroj: | BMC Geriatrics, Vol 18, Iss 1, Pp 1-8 (2018) BMC Geriatrics |
| Popis: | Background Despite progress in surgery and care, hip fracture (HF) remains a catastrophic event, burdened with high risk of mortality and disability. This study aims at identifying predictors of recovering ambulation after intensive inpatient rehabilitation within the Tuscany Region HF rehabilitation pathway. Methods All HF patients referred from acute care to the two Massa-Carrara Rehabilitation facilities January 2015–June 2017 were enrolled. Comorbidity Total Score (CIRS) defined high- or low-care setting referral. Recovery of ambulation, with or without aid, (assessed by SAHFE) was the primary outcome. Personal data, comorbidity, cognitive (MMSe) and pre-fracture function (mRANKIN) were recorded on admission. Outcomes included hospital readmission, length of stay (LOS) and home discharge. Urinary catheter, bedsores, disability (modified Barthel Index-mBI), communication disability (CDS), trunk control (TCT), pain (NRS), and ambulation were recorded (admission-discharge). Results Of 352 patients enrolled (age 83.9 ± 7.1; 80% women), 1 died and 6 were readmitted to acute-care hospital; 97% patients referred to high-care, and 64% referred to low-care, presented moderate-high comorbidity on admission. Median LOS was 22 days; 95% patients were discharged back home; daily functional gain (mBIscore/LOS) was 1.3 ± 0.7. Patients who recovered ambulation on discharge were 84%. Older age, higher comorbidity, bladder catheter, impaired trunk control, worse cognitive and functional status on admission, and pre-fracture disability were associated to poor outcome, but only higher comorbidity and impaired communication on admission predicted failure to recover ambulation on discharge. Conclusion In HF patients entitled to intensive inpatient rehabilitation, moderate-high comorbidity and impaired communication are frequent findings and predict rehabilitation failure. |
| Databáze: | OpenAIRE |
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