Risk factors related to functionality and quality of life in people over 65 years of age with hip fracture
e202207057
Keywords:
Hip fracture, Elderly, Quality of life, Functionality, Risk factorsAbstract
BACKGROUND // Hip fracture (HF) in the elderly carries high mortality and decreases functionality and quality of life after one year. The aim of this paper was to identify risk factors that influenced functionality (Barthel) and quality of life (EQ-5D) of the elderly with osteoporotic HF.
METHODS // A prospective observational study was made in people over 65 years of age with HF between October 2017 and November 2018. Clinical information was collected from the digital medical record and the scales were measured by telephone at four times: baseline, one month, six months and twelve months. Statistical analysis was made thanks to SPSS vs 25.0. Multivariate analysis was performed using a generalized linear model for repeated measures to determine the relationship of risk factors with functionality and quality of life.
RESULTS // Functionality showed significant differences (p<0.001) between baseline measurement and one month (90 points vs 50); baseline and at twelve months (90 vs 60 points); and that of the month and at twelve months (50 points vs 60). Quality of life also presented significant differences (p<0.001) between baseline and one month (0.587 vs 0.113); and baseline and twelve months (0.220). The functionality should be in transfused and with high surgical risk (p<0.05) and the quality of life will arrive in high surgical risk (p=0.017). Those older than 85 years were the ones who recovered the least after one year, as well as patients with delirium on admission and those who received transfusions. Patients with iron therapy recovered better at six months compared to those who did not and maintained this improvement at twelve months.
CONCLUSIONS // Among the main risk factors are advanced age, male sex, transfused, high surgical risk, delirium on admission and malnutrition.
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References
Aspray TJ, Hill TR. Osteoporosis and the Ageing Skeleton. In 2019. p. 453-476.
Aspray TJ. Fragility fracture: recent developments in risk assessment. Therapeutic Advances in Musculoskeletal Disease. 2015 Feb;7(1):17-25.
Iliffe S, Kendrick D, Morris R, Masud T, Gage H, Skelton D et al. Multicentre cluster randomised trial comparing a community group exercise programme and home-based exercise with usual care for people aged 65 years and over in primary care. Health Technology Assessment. 2014 Aug;18(49):1-106.
Radosavljevic NR, Nikolic D, Lazovic M, Jeremic A. Hip Fractures in a Geriatric Population-Rehabilitation Based on Patients Needs. Aging and Disease. 2014 Jun;5(3):177-182.
Turunen K, Salpakoski A, Edgren J, Törmäkangas T, Arkela M, Kallinen M et al. Physical Activity After a Hip Fracture: Effect of a Multicomponent Home-Based Rehabilitation Program—A Secondary Analysis of a Randomized Controlled Trial. Archives of Physical Medicine and Rehabilitation. 2017 May;98(5):981-988.
Smith TO, Hameed YA, Cross JL, Henderson C, Sahota O, Fox C. Enhanced rehabilitation and care models for adults with dementia following hip fracture surgery. Cochrane Database of Systematic Reviews. 2015 Jun.
Sheikh HQ, Hossain FS, Aqil A, Akinbamijo B, Mushtaq V, Kapoor H. A Comprehensive Analysis of the Causes and Predictors of 30-Day Mortality Following Hip Fracture Surgery. Clinics in Orthopedic Surgery. 2017;9(1):10.
Choi JY, Cho KJ, Kim S wook, Yoon SJ, Kang M gu, Kim K il et al. Prediction of Mortality and Postoperative Complications using the Hip-Multidimensional Frailty Score in Elderly Patients with Hip Fracture. Scientific Reports. 2017 Mar;7(1):42966.
Fernández-Moyano A, Fernández-Ojeda R, Ruiz-Romero V, García-Benítez B, Palmero-Palmero C, Aparicio-Santos R. Programa de atención integral a pacientes mayores de 65 años con fractura de cadera. Revista Clínica Española. 2014 Jan;214(1):17-23.
Pollock FH, Bethea A, Samanta D, Modak A, Maurer JP, Chumbe JT. Readmission Within 30 Days of Discharge After Hip Fracture Care. Orthopedics. 2015 Jan;38(1):e7-13.
Basques BA, Bohl DD, Golinvaux NS, Leslie MP, Baumgaertner MR, Grauer JN. Postoperative Length of Stay and 30-Day Readmission After Geriatric Hip Fracture. Journal of Orthopaedic Trauma. 2015 Mar;29(3):e115-120.
National Institute for Health and Care Excellance (NICE). The management of hip fracture in adults. National Clinical Guideline Centre (NCGC). 2017.
Kelly-Pettersson P, Samuelsson B, Muren O, Unbeck M, Gordon M, Stark A et al. Waiting time to surgery is correlated with an increased risk of serious adverse events during hospital stay in patients with hip-fracture: A cohort study. International Journal of Nursing Studies. 2017 Apr;69:91-97.
The EuroQol Group. The EuroQol Group. EuroQol-a new facility for the measurement of health-related quality of life. Health Policy. 1990;16(3):199–-208.
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Diseases [Internet]. 1987 Jan;40(5):373–83. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/0021968187901718
Bernabeu-Wittel M, Ollero-Baturone M, Moreno-Gaviño L, Barón-Franco B, Fuertes A, Murcia-Zaragoza J et al. Development of a new predictive model for polypathological patients. The PROFUND index. Eur J Intern Med [Internet]. 2011 Jun;22(3):311–7. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/21570654
Mayoral AP, Ibarz E, Gracia L, Mateo J, Herrera A. The use of Barthel index for the assessment of the functional recovery after osteoporotic hip fracture: One year follow-up. PLOS ONE [Internet]. 2019 Feb 7;14(2):e0212000. Disponible en: https://dx.plos.org/10.1371/journal.pone.0212000
The World Medical Association-WMA. Declaration of Helsinki—Ethical Principles for Medical Research Involving Human Subjects. [Internet]. Disponible en: https://www.wma.net/policies-post/wma-declaration-ofhelsinki-ethical-principles-for-medical-research-involving-human-subjects/
Kates SL, Behrend C, Mendelson DA, Cram P, Friedman SM. Hospital readmission after hip fracture. Archives of Orthopaedic and Trauma Surgery. 2015 Mar;135(3):329-337.
Mayoral AP, Ibarz E, Gracia L, Mateo J, Herrera A. The use of Barthel index for the assessment of the functional recovery after osteoporotic hip fracture: One year follow-up. PLOS ONE. 2019 Feb;14(2):e0212000.
Ojeda-Thies C, Sáez-López P, Currie CT, Tarazona-Santalbina FJ, Alarcón T, Muñoz-Pascual A et al. Spanish National Hip Fracture Registry (RNFC): analysis of its first annual report and international comparison with other established registries. Osteoporosis International. 2019 Jun;30(6):1243-1254.
Instituto de Información Sanitaria. Estadísticas comentadas: La Atención a la Fractura de Cadera en los hospitales del SNS. Ministerio de Sanidad y Política Social, editor. Madrid: Ministerio de Sanidad y Política Social; 2010.
Veronese N, Maggi S. Epidemiology and social costs of hip fracture. Injury. 2018.
Malafarina V, Reginster JY, Cabrerizo S, Bruyère O, Kanis J, Martinez J et al. Nutritional Status and Nutritional Treatment Are Related to Outcomes and Mortality in Older Adults with Hip Fracture. Nutrients. 2018 Apr;10(5):555.
Mazzola P, Ward L, Zazzetta S, Broggini V, Anzuini A, Valcarcel B et al. Association Between Preoperative Malnutrition and Postoperative Delirium After Hip Fracture Surgery in Older Adults. J Am Geriatr Soc. 2017 Jun;65(6):1222-1228.
Yoo J, Lee JS, Kim S, Kim BS, Choi H, Song DY et al. Length of hospital stay after hip fracture surgery and 1-year mortality. Osteoporosis International. 2019 Jan;30(1):145-153.
Ruiz-Romero MV, Fernández-Ojeda MDR, Castilla Yélamo J, García-Benítez JB, Calero-Bernal ML, Fernández-Moyano A. Influence of early hip fracture surgery in the elderly on mortality, readmissions, dependence and quality of life. Revista espanola de salud publica. 2020 Nov;94.
Fernandez MA, Griffin XL, Costa ML. Management of hip fracture: Fig. 1. British Medical Bulletin. 2015 Sep;115(1):165-172.
Serrano-Trenas JA, Ugalde PF, Cabello LM, Chofles LC, Lázaro PS, Benítez PC. Role of perioperative intravenous iron therapy in elderly hip fracture patients: A single-center randomized controlled trial. Transfusion (Paris). 2011 Jan;51(1):97-104.
Cid-Ruzafa J, Damián-Moreno J. Valoración de la discapacidad física: el indice de Barthel. Revista Española de Salud Publica. 1997;71(2):127-137.
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