Hip-fracture type does not affect the functional outcome after acute in-patient rehabilitation: a study of 684 elderly women.
OBJECTIVE
To investigate differences in the functional outcome between women sustaining cervical or trochanteric fractures of the hip.


METHODS
We studied 684 of 736 women admitted consecutively to a rehabilitation hospital in Italy because of their first hip fracture. Functional recovery was assessed by using Barthel index scores. Fractures were classified as either cervical (n=335) or trochanteric (n=349) on the basis of surgical and radiographic findings.


RESULTS
After acute in-patient rehabilitation, women with trochanteric fracture had a significantly lower Barthel index score than women with cervical fracture (median values were 85 and 90 respectively, interquartile ranges were 25 and 30 respectively, P=0.001). Length of stay in the hospital was significantly longer in women with trochanteric fractures (median was 37 days vs 36 days; interquartile range was 10 days vs 8 days, P=0.018). However, the differences between the two groups were no longer significant after adjustment for eight variables that affect functional ability in the same population (i.e., age, pressure ulcers, cognitive impairment, neurologic impairment, infections during the length of stay, bone mineral density, body mass index, and Barthel index scores assessed before rehabilitation). Further-more, we found no significant differences in the change of Barthel index scores during rehabilitation and in Barthel index efficiency (change in the Barthel index score after rehabilitation divided by the length of stay in hospital) between the two groups of women.


CONCLUSIONS
After adjustment for several confounders, we did not show significant differences in the functional outcome between women with cervical or trochanteric fracture of the hip.
Di Monaco
M
M
Osteoporosis Research Center, San Camillo Hospital, Turin, Italy. Medici@h-sancamillo.to.it
Vallero
F
F
Di Monaco
R
R
Tappero
R
R
Cavanna
A
A
D015502:Absorptiometry, Photon; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D006620:Hip Fractures / Q000145:classification* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000534:rehabilitation*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D020127:Recovery of Function; D012044:Regression Analysis; D018709:Statistics, Nonparametric