title: Factors affecting short-term rehabilitation outcomes of disabled elderly patients with proximal hip fracture.
abstract: OBJECTIVE
  To identify factors associated with postacute rehabilitation outcome of disabled elderly patients with proximal hip fracture.
  
  
  METHODS
  Geriatric rehabilitation center.
  
  
  METHODS
  One hundred thirty-three older patients.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  FIM instrument, motor FIM score, absolute functional gain on the FIM and motor FIM scores, relative functional gain on the FIM and motor FIM scores, rate of improvement on the FIM and motor FIM scores, proportion of patients discharged to home, and length of stay (LOS).
  
  
  RESULTS
  Mean FIM score improved by 14 points (22%) with a functional gain rate of .56 point per day. No significant differences (P>.05) were found between weight-bearing and non-weight-bearing patients regarding the above outcome measures. Functionally independent and cognitively intact patients achieved significantly better score changes and rates of improvement and showed a higher ability to extract their rehabilitation potential than dependent and cognitively impaired patients. Their LOSs were significantly shorter. Patients with latency time (time delay from fracture to operation) of more than 5 days and patients with a history of stroke had significantly longer LOSs. Mini-Mental State Examination score, albumin levels on admission, and prefracture functional status were the most important parameters associated with FIM discharge scores (r=.756) and relative functional gain on the FIM (r=.583). Depression was the most important factor associated with LOS in patients with weight-bearing instructions on admission. The presence of a caregiver was the significant predictive value variable for returning home.
  
  
  CONCLUSIONS
  Cognitive function, nutritional status, preinjury functional level, and depression were the most important prognostic factors associated with rehabilitation success of older patients with proximal hip fracture. Of these, depression and nutritional status are correctable, and early intervention may improve rehabilitation outcome.
authors.affiliation: Beit Rivka Geriatric Rehabilitation Center, Petach Tikva, Israel. avitalhe@clalit.org.il
authors.forename: Avital
authors.initials: A
authors.lastname: Hershkovitz
authors.forename: Zulicha
authors.initials: Z
authors.lastname: Kalandariov
authors.forename: Vered
authors.initials: V
authors.lastname: Hermush
authors.forename: Roni
authors.initials: R
authors.lastname: Weiss
authors.forename: Shai
authors.initials: S
authors.lastname: Brill
mesh_terms: D000369:Aged, 80 and over; D017028:Caregivers; D003072:Cognition Disorders / Q000150:complications; D003863:Depression / Q000150:complications; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D016330:Frail Elderly; D006620:Hip Fractures / Q000534:rehabilitation*; D006801:Humans; D007557:Israel; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D009483:Neuropsychological Tests; D009752:Nutritional Status; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012044:Regression Analysis; D012709:Serum Albumin / Q000032:analysis; D020521:Stroke / Q000150:complications; D013997:Time Factors
chemical_list: D012709:Serum Albumin