Prediction of postoperative ambulatory status 1 year after hip fracture surgery.
Hirose J, Ide J, Yakushiji T, Abe Y, Nishida K, Maeda S, Anraku Y, Usuku K, Mizuta H. Prediction of postoperative ambulatory status 1 year after hip fracture surgery.


OBJECTIVE
To assess the validity of Estimation of Physiologic Ability and Surgical Stress (E-PASS) for predicting the postoperative risk and ambulatory status long-term follow-up after hip fracture surgery and to establish an algorithm for predicting their ambulatory status.


METHODS
Cohort study.


METHODS
Twelve hospitals belonging to the regional network for hip fracture in Japan.


METHODS
The study population was composed of 421 patients; 268 underwent surgery between April 2004 and March 2006 (group A), and 153 were treated surgically between April 2006 and March 2007 (group B). All were operated at 3 surgical hospitals and, subsequently, transferred to 9 rehabilitation centers.


METHODS
Not applicable.


METHODS
We evaluated various factors, including their E-PASS scores to determine whether there was a correlation with the patients' mortality rate and their ability to walk at discharge and 1 year after surgery (group A). Using multiple regression analysis, we then developed algorithms to predict the ability of elderly patients to walk after hip fracture surgery. We applied the algorithms to group B patients and compared their actual and predicted ambulatory status.


RESULTS
In group A patients, the postoperative walking ability and mortality rate were highly correlated with their E-PASS scores and dementia status. In group B, our algorithms exhibited good correlations between the predicted and actual walking ability at both time points (rho=0.6, P<.001).


CONCLUSIONS
In candidates for hip fracture surgery, the E-PASS scores exhibited a good correlation with the patients' functional and survival prognoses, and the algorithm including E-PASS scores and dementia status can accurately estimate the ambulatory status at discharge and 1 year after surgery.
Hirose
Jun
J
Department of Medical Information Science and Administration Planning, Kumamoto University, Kumamoto, Japan. hirojun-mk@umin.ac.jp
Ide
Junji
J
Yakushiji
Toshitake
T
Abe
Yasuyuki
Y
Nishida
Kimiaki
K
Maeda
Satoshi
S
Anraku
Yoshihisa
Y
Usuku
Koichiro
K
Mizuta
Hiroshi
H
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015331:Cohort Studies; D003704:Dementia / Q000150:complications; D005260:Female; D006620:Hip Fractures / Q000150:complications / Q000401:mortality* / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011379:Prognosis; D012044:Regression Analysis; D012737:Sex Factors; D016138:Walking