Patient-reported outcomes at acute hospital stay and four months after hip fracture surgery. A register and questionnaire study

Abstract

Introduction: The large and increasing number of hip fracture patients, in combination with the large impact that this is having on daily living activities, is emphasizing the importance of identifying factors that have a detrimental impact on post-operative outcomes. There are benefits to planning the ward in a way that prevents a steep decline in recovery after hip fracture surgery. Adding the patient`s perspective into the healthcare assessment, via shared healthcare decision-making, allows the patient’s needs and preferences to be taken fully into account. The aim of this study was to identify factors that predict how patients recover after hip fracture surgery.Methods: A descriptive quality register/questionnaire study in acute orthopaedic wards, 2 to 5 days after surgery, with a follow-up 4 months later. The patients included were ≥65 years of age and had been previously healthy and living independently before the hip fracture.Results: The participants in this study had returned to their own homes after 4 months, but only 21% reported themselves as being fully or almost fully recovered. In several domains of recovery, all 3 age groups (65-74, 75-84 and 85-97) reported different challenges both during their acute hospital stay and at the 4 months follow-up. The recovery phase is heterogeneous and requires individual care. The way that this is planned has an influence on patient outcome.Conclusion: Patients sustaining a hip fracture are heterogeneous and different age groups experience different challenges. At 4 months follow-up, one fifth of the participants reported themselves fully or almost fully recovered and most of them had returned to their own homes. The Swedish National Hip Fracture Register and the patient-reported questionnaires employed in this study are appropriate tools to audit further development of healthcare to improve quality of life after hip fracture surgery.