Poster 105: Functional Capacity of Elderly People Living Alone in Their Homes Prior to the Acute Care Admission for a Hip Fracture: A Cohort Study of 2 Rehabilitation Settings

Abstract

Objective: To compare, in a prospective analysis, the functional outcome of 2 rehabilitation settings after discharge from the acute hospital, for elderly patients who were living alone in their homes before suffering a hip fracture. Design: Longitudinal design with prospectively collected data. Setting: Rehabilitation unit in level III trauma center. Participants: 215 patients aged 65 years and older admitted from their own home and living alone to a public tertiary university hospital with acute hip fracture diagnosis, who underwent rehabilitation at home or at a convalescent care unit between 2003 and 2006. Intervention: Rehabilitation at home or at a convalescent care unit. Main Outcome Measures: All patients were evaluated immediately after admission to the hospital and after rehabilitation discharge, using a specially designed questionnaire that included social, medical, functional, and orthopedic variables. The statistical analysis was done with SPSS, version 13, and an inferential bivariate analysis was applied. The level of statistical significance used was P≤.05. Results: No statistically significant differences (age, sex distribution, social support, comorbidities, mental status, previous functional level, type of fracture, surgical treatment) in either series were found. Patients discharged home with rehabilitation ambulated better (not able, 4.6% vs 2.1%; indoors with walker, 16.5% vs 34%; indoors with crutches, 27.5% vs 23.4%; outdoors with crutches, 51.4% vs 40.4%; P=.032) with a lower mean number of physical therapy sessions (24 vs 51, P<.01) and a lower mean discharge time (61d vs 80d, P<.01) than patients discharged to a convalescent care unit. Conclusions: The home rehabilitation program presents great advantages by returning patients with hip fractures to their home environment, and may promote earlier functional independence.