Initial functional recovery as a measure for rehabilitation outcome in post-acute hip fractured patients

Abstract

Background: The assessment of immediate functional change after hip fracture surgery may assist in predicting rehabilitation outcome and improve program efficiency.

Objective: To evaluate the potential of the initial functional recovery measure in predicting rehabilitation outcome of hip fractured patients.

Design: Retrospective cohort study.

Setting: Post-acute geriatric rehabilitation center.

Participants: A total of 630 hip fractured patients admitted from 1/2016-6/2019.

Methods: The initial functional recovery, a measure of functional change from the time of surgery to rehabilitation was calculated for each patient. The association between initial functional recovery and clinical and demographic variables was assessed by the Mann-Whitney and chi-square tests. A multiple linear regression model evaluated the association between initial functional recovery and the discharge functional independence measure score. Regression analysis estimated the association between initial functional recovery and the achievement of a favorable outcome measure.

Results: A good correlations were found between initial functional recovery and rehabilitation outcomes but not length of stay (p < 0.001). Multiple linear regression analysis showed that after adjustment for potential confounding variables, the higher the initial functional recovery, the better the discharge functional independence measure score (r² = 0.783; p < 0.001). Logistic regression revealed that a high initial functional recovery was significantly associated with a higher probability of achieving a favorable functional gain (OR = 1.093; 95% CI = 1.04-1.15, P < 0.001).

Conclusion: Initial functional recovery is a good predictor of rehabilitation outcomes in hip fractured patients, and may be utilized in decision-making regarding the rehabilitation program in addition to coordinating expectations with patients and their caregivers.

Keywords: Hip fracture; Initial functional recovery; Outcome; Rehabilitation.