title: Functional outcome of elderly hip fracture patients: does diabetes matter?
abstract: The purpose of this study was to investigate whether diabetes mellitus may affect the functional outcome of hip fractured patients. We studied 759 consecutive patients admitted for hip fracture rehabilitation, out of whom 18.2% were diabetics. The functional outcomes of diabetics and nondiabetics were assessed by the functional independence measurement scale (FIM) at admission and discharge. Data were analyzed by t-tests, Pearson correlation, and chi-square test as well as by multiple logistic regression analysis. Compared with nondiabetics, diabetic patients were slightly younger (p=0.003) and more hyperlipidemic (p=0.01), had a higher prevalence of previous stroke (p=0.03) and lower cognitive Mini-Mental State Examination (MMSE) scores (p=0.007). Absolute and relative FIM parameters, at admission and discharge, were similar in both groups. A multiple logistic regression analysis showed that diabetes was independently, and inversely, associated with male gender [odds ratio (OR), 2.11 (95% CI, 1.41-3.18)] and higher admission motor-FIM [OR, 1.05 (95% CI, 1.03-1.07)], whereas higher cognitive scores upon admission emerged as being "protective" for being in the motor-FIM gain <20 [OR, 0.94 (95% CI, 0.91-0.97)]. However, diabetes was not associated with any of the parameters indicating unsuccessful rehabilitation. The findings suggest that there is no difference in the functional outcome of diabetic and nondiabetic patients, presenting for rehabilitation after surgery of hip fractures. Diabetes should not be considered as adversely affecting rehabilitation of such patients.
authors.affiliation: Department of Geriatric Medicine and Rehabilitation, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel. exm42@sheba.health.gov.il
authors.forename: E H
authors.initials: EH
authors.lastname: Mizrahi
authors.forename: Y
authors.initials: Y
authors.lastname: Fleissig
authors.forename: M
authors.initials: M
authors.lastname: Arad
authors.forename: A
authors.initials: A
authors.lastname: Adunsky
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003071:Cognition; D048909:Diabetes Complications / Q000503:physiopathology*; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006620:Hip Fractures / Q000209:etiology* / Q000503:physiopathology* / Q000534:rehabilitation; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D016017:Odds Ratio; D012307:Risk Factors; D016896:Treatment Outcome