Prediction of postoperative morbidity, mortality and rehabilitation in hip fracture patients: the cumulated ambulation score.
OBJECTIVE
To validate the cumulated ambulation score as an early postoperative predictor of short-term outcome in hip fracture patients.


METHODS
Prospective, descriptive study.


METHODS
An orthopaedic hip fracture unit in a university hospital.


METHODS
Four hundred and twenty-six consecutive hip fracture patients with an independent walking function admitted from their own home. Rehabilitation followed a well-defined multimodal rehabilitation regimen and discharge criteria.


METHODS
Admission tests with a new mobility score to assess prefracture functional mobility and a short mental score for cognitive dysfunction were performed. On the first three postoperative days patients were assessed with the cumulated ambulation score consisting of a cumulated assessment of simple ambulation characteristics with a score from 0 to 18 (fully mobile). The three assessments were correlated to short-term outcome parameters.


RESULTS
The cumulated ambulation score was a highly significant predictor for length of hospitalization, time to discharge status, 30-day mortality and postoperative medical complications (P < 0.001 for all). The cumulated ambulation score was superior in its association with all postoperative outcome parameters to both the New Mobility Score and the mental score. A cumulated ambulation score of > or = 10 correlated with a 99% survival at one month and 93% discharge to own home.


CONCLUSIONS
The cumulated ambulation score is a potentially valuable score for early prediction of short-term postoperative outcome after hip fracture surgery.
Foss
Nicolai B
NB
Department of Anaesthesiology, Hvidovre University Hospital, Copenhagen DK-2650, Denmark. nbf@comxnet.dk
Kristensen
Morten T
MT
Kehlet
Henrik
H
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006620:Hip Fractures / Q000534:rehabilitation* / Q000601:surgery*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome; D016138:Walking