Gait Reacquisition Rate, Home Outcome Rate, and Gait Prognosis in Patients with Femoral Neck Fractures and Mental Illness - A Multicenter Study
- PMID: 32885087
- PMCID: PMC7459130
- DOI: 10.2490/prm.20200019
Gait Reacquisition Rate, Home Outcome Rate, and Gait Prognosis in Patients with Femoral Neck Fractures and Mental Illness - A Multicenter Study
Abstract
Objective: A total of 183 patients admitted to five hospitals for proximal femoral fractures and psychiatric disorders were examined to determine whether their physical function could be improved by rehabilitation and to identify factors that affected home discharge.
Methods: We conducted surveys to collect data regarding patients' age, sex, type of mental illness, location at time of injury, complications, Charlson Comorbidity Index, Global Assessment of Functioning scale scores, surgical technique, time from surgery to the start of rehabilitation at the target hospital, rehabilitation duration, results of cognitive function tests (e.g., the Mini Mental Status Examination), walking ability before the injury, final walking ability, functional independence measure (FIM) of the patient's activities of daily living at the start and end of treatments, and discharge destinations.
Results: The motor function index showed a significant improvement from an average of 36.0 points at admission to an average of 53.0 points at discharge. Overall, 47.9% of patients who were able to walk before injury could regain gait ability. The discharge rate to the patient's home was 15.8%.
Conclusions: The gait reacquisition rate for patients with femoral neck fractures and mental illness admitted to a psychiatric ward was 47.9%, which was lower than that reported in previous studies, but higher than that for dementia patients. Binomial logistic regression analysis identified the following predictive items for home discharge: whether the fracture occurred at home, FIM cognition item scores at admission, and total and motor item scores at discharge. The derived equation had a high hit rate of 80.9%.
Keywords: Femoral neck and trochanteric fractures; Mental illness; Multicenter study.
©2020 The Japanese Association of Rehabilitation Medicine.
Conflict of interest statement
CONFLICT OF INTEREST: The authors declare no conflicts of interest.
References
-
- Tokyo Metropolitan Hospital Management Headquarters Service Promotion Department: The 17th count result of incident accident report in Tokyo Hospital. 2019. http://www.byouin.metro.tokyo.jp/hokoku/anzen/iryouanzen301112.html(Febr... 13, 2019)
-
- Hayashi Y: Social conditions surrounding falls. The impact of the fall on the medical economy. MB Med Rehab 2006;65:1–9. In Japanese
-
- Ministry of Health, Labour and Welfare: 2017 Medical institution (static condition/movement) investigation. Overview of hospital report. 2019. https://www.mhlw.go.jp/toukei/saikin/hw/iryosd/17/ (February 13, 2019)
-
- Supervised by Japan Orthopedic Association: Japanese Society for Fracture Treatment: Clinical guidelines for femoral neck/trochanteric fractures. Second revised edition. 2011, Nankodo, pp 118–119. In Japanese.
-
- Wakasugi M,Matsueda M,et al. : Examination of postoperative walking ability in the femoral proximal fracture. Orthop Surg Traumatol 2014;57:1635–1639. In Japanese.
