Prefracture functional level evaluated by the New Mobility Score predicts in-hospital outcome after hip fracture surgery.
OBJECTIVE
Clinicians need valid and easily applicable predictors of outcome in patients with hip fracture. Adjusting for previously established predictors, we determined the predictive value of the New Mobility score (NMS) for in-hospital outcome in patients with hip fracture.


METHODS
We studied 280 patients with a median age of 81 (interquartile range 72-86) years who were admitted from their own homes to a special hip fracture unit. Main outcome was the regain of independence in basic mobility, defined as. independence in getting in and out of bed, sitting down and standing up from a chair, and walking with an appropriate walking aid. The Cumulated Ambulation score was used to evaluate basic mobility. Predictor variables were NMS functional level before fracture, age, sex, fracture type, and mental and health status.


RESULTS
Except for sex, all predictor variables were statistically significant in univariate testing. In multiple logistic regression analysis, only age, NMS functional level before fracture, and fracture type were significant. Thus, patients with a low prefracture NMS and/or an intertrochanteric fracture would be 18 and 4 times more likely not to regain independence in basic mobility during the hospital stay, respectively, than patients with a high prefracture level and a cervical fracture, respectively. The model was statistically stable and correctly classified 84% of cases.


CONCLUSIONS
The NMS functional level before fracture, age, and fracture type facilitate prediction of the in-hospital rehabilitation potential after hip fracture surgery.
Kristensen
Morten T
MT
Division of Physical Therapy, Health Sciences Center, Lund University, Sweden.
Foss
Nicolai B
NB
Ekdahl
Charlotte
C
Kehlet
Henrik
H
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006304:Health Status; D006620:Hip Fractures / Q000175:diagnosis / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D008297:Male; D008603:Mental Health; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D011379:Prognosis; D020127:Recovery of Function; D012737:Sex Factors; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*
Disabil Rehabil. 2005 Sep 30-Oct 15;27(18-19):1091-7
16278177
Age Ageing. 1974 Aug;3(3):152-7
4463714
Clin Orthop Relat Res. 1995 Jan;(310):150-9
7641432
Clin Rehabil. 2009 Dec;23(12):1116-23
19923208
Acta Orthop Scand. 2000 Feb;71(1):34-8
10743990
J Bone Joint Surg Br. 2008 Aug;90(8):1073-8
18669966
Am J Surg. 2002 Jun;183(6):630-41
12095591
J Rehabil Med. 2007 Sep;39(7):507-12
17724548
Clin Biomech (Bristol, Avon). 2009 Feb;24(2):218-24
19091449
Aust N Z J Surg. 1999 Oct;69(10):723-5
10527349
Injury. 2008 Oct;39(10):1164-74
18555253
J Bone Joint Surg Am. 2006 Oct;88(10):2115-23
17015586
Arch Phys Med Rehabil. 2002 Feb;83(2):158-64
11833017
J Rehabil Med. 2008 Jul;40(7):589-91
18758678
J Orthop Trauma. 2000 Jan;14(1):26-30
10630799
Clin Orthop Relat Res. 1993 Feb;(287):76-81
8448963
Clin Rehabil. 2006 Aug;20(8):701-8
16944827
Ugeskr Laeger. 2005 Aug 29;167(35):3297-300
16138973
Age Ageing. 1995 Mar;24(2):96-8
7793343
Physiother Res Int. 2009 Mar;14(1):30-41
18646243
Age Ageing. 2008 Mar;37(2):173-8
18349013
J Bone Joint Surg Br. 1993 Sep;75(5):797-8
8376443
Br J Anaesth. 2009 Jan;102(1):111-6
19059921
Clin Orthop Relat Res. 2004 Aug;(425):64-71
15292789