Does Rehabilitation Matter in Patients With Femoral Neck Fracture and Cognitive Impairment?: A Prospective Study of 246 Patients
2010 (English)In: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 91, no 1, 51-57 p.Article in journal (Refereed) Published
Objective: To identify factors associated with preserved walking ability and Katz activities of daily living (ADLs) index at 4-month and 12-month follow-up in cognitively impaired patients with femoral neck fracture. Design: Population-based cohort study. Setting: A multicenter study of the Stockholm Hip Fracture Group including 4 university hospitals. Participants: Consecutive patients (N=246) with femoral neck fracture, older than 65 years (mean, 84y; 72% women) with cognitive impairment (known dementia or low [0-2 points] score) in Short Portable Mental Status Questionnaire [0-10 points]) and able to walk before the fracture. Interventions: Not applicable. Main Outcome Measure: Walking ability and ADLs index at 4-month and 12-month follow-up. Results: Significant predictors of preserved walking ability at 12-month follow-up were discharge to rehabilitation unit (odds ratio [OR]=2.83: confidence interval [CI], 1.1-7.26; P=.03) and walking ability before the fracture (OR=8.98; Cl, 3.52-22.93; P<.001), while type of surgery was not (P=.197). Analyses were adjusted for age, sex, American Society of Anesthesiologists score, fracture type, and surgical method. Corresponding predictors of preserved Katz ADLs index at 12-month follow-up, after adjustment for age and sex, were discharge to rehabilitation unit (OR=5.33; Cl, 1.44-19.65: P=.012) and ADLs index before fracture (OR=2.5; Cl. 1.8-3.5: P<.001), while type of surgery was not (P=.376). Conclusions: Discharge to rehabilitation unit, a factor we can influence, was associated with preserved walking ability and ADLs index in cognitively impaired patients with hip fracture.
Place, publisher, year, edition, pages
2010. Vol. 91, no 1, 51-57 p.
Activities of daily living, Dementia, Hip fractures, Rehabilitation, Walking
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-137449DOI: 10.1016/j.apmr.2009.09.005ISI: 000277417300008OAI: oai:DiVA.org:uu-137449DiVA: diva2:378518