Pain perception during the rehabilitation phase following traumatic hip fracture in the elderly is an important prognostic factor and treatment tool.
OBJECTIVE
To evaluate the role of pain perception on admission to geriatric rehabilitation on the functional recovery after rehabilitation treatment in elderly patients with hip fracture and on the length of stay.


METHODS
One hundred and sixty-five community dwelling elderly 65-year-old and over (mean age of 78 years), following recent operated traumatic hip fracture without clinical evidence for another acute medical or surgical condition were assessed regarding age, sex, chronic medical conditions, pre-fracture functional status, type of fracture and of operation, pain perception, and cognitive status. Pain was measured using the Visual Analogue Score (VAS). Functional status was measured using the Functional Independence Measurement (FIM). Activities of Daily Living (ADL) were assessed using the Katz index.


RESULTS
The average VAS score on admission was 7.38 +/- 1.20 and on discharge 3.67 +/- 1.18. Pain on admission inversely correlated to family support, function prior to fracture and cognitive status on admission, and correlated positively with depressed mood. With every increase of one point in VAS on admission above 4 points, the FIM on discharge decreased by 8.77 and the length of stay increased by 4.76 days.


CONCLUSIONS
Pain intensity may add a valuable dimension for the prognostic evaluation of the patients with hip fractures. Inadequate early patient assessment and associated treatment impact on the patients' functional outcome, prolonged duration of rehabilitation treatment, and therefore, in addition to socio-economic effect, increase the cost to the local health care setting.
Arinzon
Zeev
Z
The Orthopaedic Surgery Department, Spine Unit, Sapir Medical Center, Kfar Saba, Israel. arinzon@walla.co.il
Gepstein
Reuven
R
Shabat
Shay
S
Berner
Yitshal
Y
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D016000:Cluster Analysis; D005260:Female; D015577:Geriatric Assessment; D006620:Hip Fractures / Q000175:diagnosis* / Q000534:rehabilitation*; D006801:Humans; D007902:Length of Stay; D008297:Male; D015999:Multivariate Analysis; D010146:Pain; D011379:Prognosis