Persistent pain in frail older adults after hip fracture repair.
OBJECTIVE
To identify factors associated with persistent hip pain in elderly hip fracture patients with physical frailty.


METHODS
Cohort study.


METHODS
Community-based study conducted at academic medical center.


METHODS
Eighty-eight men and women (mean age+/-standard deviation 80+/-7 years) with a recent hip fracture (mean 14.5+/-4.8 weeks after hip fracture repair) and physical frailty, defined as a modified Physical Performance Test Score between 12 and 28, enrolled in an exercise intervention trial.


METHODS
Dependent variable was self-report of moderate to severe regional hip pain in the week preceding the baseline interview. Independent variables were self-reported demographic information, health characteristics, and activity of daily living (ADL) function; Yesavage Mood Score (YMS); 36-item Short Form percentile scores; and objective measurements of lower extremity strength, range of motion, balance, and gait.


RESULTS
Forty-two percent of the sample reported moderate or severe hip pain at the baseline assessment. Moderate/severe pain was related to difficulty with ADL performance and multiple measures of quality of life. Variables independently associated with moderate/severe hip pain were frequency of pain medication use (adjusted odds ratio (AOR)=5.75, 95% confidence interval (CI)=2.23-14.82, P=.003), YMS score (AOR=2.69, 95% CI=1.18-6.12, P=.02), and knee extension at 60 degrees /s in the fractured limb (AOR=0.96, 95% CI=0.92-1.0, P=.05, model coefficient of determination=0.34).


CONCLUSIONS
Persistent hip pain is a frequent symptom in frail elderly community-dwelling hip fracture patients. Pain medication use, symptoms of depression, and skeletal muscle weakness of the fractured leg are independent correlates of moderate to severe hip pain in this patient population. Clinicians should assess for, and address, persistent pain in this patient population.
Herrick
Cynthia
C
Department of Internal Medicine, School of Medicine, Washington University, St Louis, Missouri 63108, USA.
Steger-May
Karen
K
Sinacore
David R
DR
Brown
Marybeth
M
Schechtman
Kenneth B
KB
Binder
Ellen F
EF
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation*; D015331:Cohort Studies; D005260:Female; D016330:Frail Elderly; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010149:Postoperative Pain / Q000453:epidemiology*; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D014481:United States / Q000453:epidemiology