期刊
AGING CLINICAL AND EXPERIMENTAL RESEARCH
卷 35, 期 5, 页码 1063-1071出版社
SPRINGER
DOI: 10.1007/s40520-023-02378-y
关键词
Hip fractures; Older people; Orthogeriatrics; Mortality; Gender; Functional recovery
This retrospective study aimed to evaluate functional autonomy and mortality in older adults with hip fractures, and determine if gender affected outcome. The study found that functional loss is greatest in the first 6 months after discharge and is associated with increased risk of death at 1 year.
BackgroundProximal femur fractures have a negative impact on loss of functional autonomy and mortality.ObjectiveThe aim of this retrospective study was to evaluate functional autonomy and mortality in a group of older adults with hip fractures managed in an orthogeriatric setting 12 months after discharge and to determine if gender affected outcome.MethodsIn all participants, we assessed clinical history, functional pre-fracture status using activities of daily living (ADL) and in-hospital details. At 12 months after discharge, we evaluated functional status, place of residence, hospital readmissions and mortality.ResultsWe studied 361 women and 124 men and we observed a significant reduction in the ADL score at 6 months (1.15 +/- 1.58/p < 0.001 in women and 1.45 +/- 1.66/p < 0.001 in men). One-year mortality (33.1% in men and 14.7% in women) was associated with pre-fracture ADL score and reduction in ADL at 6 months (HR 0.68/95%, CI 0.48-0.97/p < 0.05 and HR 1.70/95%, CI 1.17-2.48/p < 0.01, respectively) in women, and new hospitalisations at 6 months and polypharmacy in men (HR 1.65/95%, CI 1.07-2.56/p < 0.05 and HR 1.40/95%, CI 1.00-1.96/p = 0.05, respectively) in Cox's regression model.Discussion and ConclusionsOur study suggests that functional loss in older adults hospitalised for proximal femur fractures is greatest in the first 6 months after discharge, and this increases the risk of death at 1 year. Cumulative mortality at 12 months is higher in men and appears to be related to polypharmacy and new hospital admissions 6 months after discharge.
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