Patient, surgical and hospital factors predicting actual first-day mobilisation after hip fracture surgery: An observational cohort study

被引:5
作者
Woodcroft-Brown, Victoria [1 ]
Bell, Jack [2 ]
Pulle, Chrysanth Ranjeev [1 ]
Mitchell, Rebecca [3 ]
Close, Jacqueline [4 ,5 ]
McDougall, Catherine [1 ,6 ]
Hurring, Sarah [7 ]
Sarkies, Mitchell [3 ,8 ,9 ]
机构
[1] Prince Charles Hosp, Metro North Hosp & Hlth Serv, Brisbane, Qld, Australia
[2] Prince Charles Hosp Allied Hlth Res Collaborat AHR, Prince Charles Hosp, Brisbane, Qld, Australia
[3] Macquarie Univ, Australian Inst Hlth Innovat, Fac Med Hlth & Human Sci, Sydney, NSW, Australia
[4] Univ New South Wales, Neurosci Res Australia, Falls Balance & Injury Res Ctr, Sydney, NSW, Australia
[5] Univ New South Wales, Sch Clin Med, Sydney, NSW, Australia
[6] Univ Queensland, Sch Med, Brisbane, Qld, Australia
[7] Older Persons Hlth Specialist Serv, Te Whatu Ora Waitaha, Canterbury, New Zealand
[8] Univ Sydney, Sydney Sch Publ Hlth, Fac Med & Hlth, Level 7 D18 Susan Wakil Hlth Bldg, Sydney, NSW 2006, Australia
[9] Implementat Sci Acad, Sydney Hlth Partners, Sydney, NSW, Australia
基金
英国医学研究理事会;
关键词
early ambulation; hip fractures; orthopedic procedures; osteoporotic fractures; physical therapy specialty; MORTALITY; MORBIDITY; OUTCOMES; PERIOD; TRENDS;
D O I
10.1111/ajag.13312
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Objectives: To examine patient, surgical and hospital factors associated with Day-1 postoperative mobility after hip fracture surgery in older adults. Methods: A cohort study using Australia and New Zealand Hip Fracture Registry was conducted. Participants were aged older than 50 years and underwent hip fracture surgery between 1 January 2020 and 31 December 2020 inclusive. The outcome was standing and step transferring out of bed onto a chair and/or walking Day-1 after hip fracture surgery. Results: Mean age was 82 years and 68% were women. Of 12,318 patients with hip fracture, 5981 (49%) actually mobilised Day-1. Odds of actual first-day mobilisation were lower for individuals usually walking with either stick or crutch (OR = 0.71, 95% CI 0.62-0.82) or two aids or frame (OR = 0.57, 95% CI 0.52-0.64) or wheelchair/bed bound (OR = 0.24, 95% CI 0.17-0.33); who had impaired cognition preadmission (OR = 0.57, 95% CI 0.51-0.64); from aged care facilities (OR = 0.59, 95% CI 0.52-0.67); had an American Society of Anaesthesiologists grade 2 (OR = 0.63, 95% CI 0.41-0.97), 3 (OR = 0.31, 95% CI 0.20-0.47) or 4 or 5 (OR = 0.21, 95% CI 0.14-0.32); surgery delay >48 h (OR = 0.81, 95% CI 0.71-0.91); and restricted/non-weight-bearing status immediately postoperatively (OR = 0.53, 95% CI 0.42-0.67). Conclusions: Both non-modifiable and modifiable patient and surgical factors influence first-day mobilisation after hip fracture surgery. Reducing time to surgery might assist future quality improvement efforts to increase Day-1 postoperative mobility.
引用
收藏
页码:600 / 608
页数:9
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