Post-90 hip fracture patients spring back well
Study finds 50% regain activities of daily living
It used to be that inaccurate theories about rehab for older patients were as accepted as tried-and-true cliches like "the early bird catches the worm." But contrary to widely held beliefs, older doesn’t always mean a lesser chance for functional recovery, a study by orthopedists at Presbyterian Hospital in New York City finds.
The study of 45 hip fracture patients ages 90 and older finds that 50% returned to their preinjury mobility and activities of daily living, reports study co-author Heidi Michelson, MD, of the hospital’s department of orthopedic surgery. This compares favorably with studies finding that the 50% of all hip fracture patients recover their preinjury basic activities of daily living.
"Despite thoughts that increased age is a determinant in return to preinjury function, our study demonstrates that age does not preclude maintenance of living accommodation, basic activities of daily living or ambulatory capacity," she says.
"These figures . . . underscore the need to draw attention to hip fracture management in the over-90-year-old age group. Identification and optimization of factors that play a role in post-operative morbidity, mortality, and function in this often-underestimated age group can significantly improve both medical and economic outcomes," Michelson told Rehab Continuum Report.
The Presbyterian Hospital study concluded that important factors in a successful patient outcome are preinjury mobility and prevention of postoperative complications, specifically pulmonary problems, Michelson says. Seven of the 45 patients studied developed pneumonia, and all but one of them died, primarily within three months.
An average follow-up of 14 months was obtained for 43 of the 48 patients. In-hospital mortality was 6.3%; at one year, mortality was 33% among the patients. In addition, 44% were able to return to their prior living environments.
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