[What prognostic factors correlate with activities of daily living (Barthel Index) 1 year after para-articular hip fracture? A prospective observational study].
The aim of this prospective study was to identify prognostic factors predicting post-operative outcome in patients one year after their hip fracture.


METHODS
From October 1996 until September 1997 all patients (n = 98) treated for a hip fracture in our hospital were prospectively included into the study. Follow up was performed at three, six and twelve months after the injury. The main outcome variable was the activity of daily living measured by the Barthel-Index. An univariate analysis of the variables age, gender, ASA-classification, type of fracture and treatment, length of stay and rehabilitation was performed and all these variables were correlated with the Barthel-Index. A multiple logistic regression was performed for identification of prognostic factors predicting outcome.


RESULTS
The one year lethality was 33% (n = 31). All patients younger than 75 years reached their preoperative activity level at one year follow up. Patients with age of 75 years or more experienced a reduction of their activities of daily living of 20%. The ADL-differences of both groups at the follow up after 3, 6 and 12 months showed a significant p-value (p < 0.001). The ADL-differences between the group of patients with or without a transfer to a specialized rehabilitation center were not significant. The multivariate analysis showed that the preoperative use of the Barthel-Index was the best prognostic factor for outcome until one year after the injury.


CONCLUSIONS
The preoperative Barthel-Index should be seriously considered for therapeutic decision making in patients with hip fractures.
Simanski
C
C
Unfallchirurgische Abteilung, Chirurgische Klinik Köln-Merheim, II. Chirurgischer Lehrstuhl, Universität Köln. Christian.Simanski@uni-koeln.de
Bouillon
B
B
Lefering
R
R
Zumsande
N
N
Tiling
T
T
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011379:Prognosis