Prognostic factors for self-rated function and perceived health in patient living at home three months after a hip fracture

Abstract

Purpose: To explore the relationship between prefracture sociodemographic and health characteristics, basic activities of daily living, instrumental activities of daily living and perceived health 3 months after a hip fracture aged 65 or older.Methods: Age, sex, living alone or not, use of walking aids and whether they had experienced another fall during the previous 6 months, were recorded in hospital and at a three-month follow-up. A total of 277 patients were included. The Barthel Index, the Nottingham Extended ADL Index, the Short Form-12 questionnaire, and the Mini Mental State Examination were used.Results: Prefracture use of a walking aid outdoors was a predictor of postfracture dependency in basic activities of daily living: odds ratio (OR) 2.0, 95% confidence intervals (CI 1.1–3.6), reduced score in instrumental activities of daily living (OR 1.8; 95% CI 1.0–3.2) and reduced perceived physical health (p = 0.04). Prefracture instrumental activity of daily living was a predictor for dependency in basic activities of daily living (OR 3.3; 95% CI 1.7–6.3). Cognitive dysfunction was a risk factor for dependency in basic activities of daily living (OR 0.1; 95% CI 0.01–0.7).Conclusions: Prefracture use of outdoor walking aids, perceived physical health, cognitive function, instrumental activity of daily living and female gender were all predictors explaining the three-month outcomes for basic activities of daily living and instrumental activity of daily living.Implications for RehabilitationThe use of a walking aid before hip fracture may be a poor prognostic factor affecting 3-months rehabilitation outcome of hip-fractured patients.It is of importance to having knowledge of the patient’s prefracture status when planning rehabilitation.