Independencia para actividades de la vida diaria en ancianos previamente autónomos intervenidos por fractura de cadera secundaria a una caída tras 6 meses de evolución

Abstract

ObjectiveTo measure recovery of independence in activities of daily living (ADL) 6 months after surgery in elderly patients (previously independent and without cognitive impairment) with hip fracture caused by a fall. MethodWe performed a longitudinal, prospective cohort study of patients who were previously independent for ADL, or had mild dependence, and who showed no cognitive impairment. Consecutive sampling was performed. The variables studied were age, sex, habitual residence, type of hip fracture, mental status (SPMSQ Pfeiffer), and independence in ADL (according to Barthel Index [BI]) prior to the fall and 6 months after the fall. ResultsThe study included 207 patients. There was a predominance of female sex (74.4%) and pertrochanteric fractures (45.9%). The mean age was 80.17 years old (SD=6.95), and 7.7% were institutionalized. Six months after surgery, the mean BI score was 73.37 (SD=26.76) (versus 90.05 before the fall), 16.8% showed urinary incontinence (versus 5.9%), 59.2% walked without assistance (versus 82.4%) and 24.6% climbed stairs unaided (versus 50.7%). The ability to walk down the street was regained in 64.6% (versus 82.1% before the fall). Recovery of autonomy for ADL was statistically significantly lower in patients unable to walk outdoors, who were institutionalized or who had mild cognitive impairment before the fall. ConclusionsOnly 33.6% of patients regained prior levels of autonomy 6 months after surgery.