Two-year effects of interdisciplinary intervention for hip fracture in older Taiwanese.
OBJECTIVE
To explore the 2-year outcomes of an interdisciplinary intervention for elderly patients with hip fracture.


METHODS
Randomized experimental design.


METHODS
A 3,000-bed medical center in northern Taiwan.


METHODS
Patients with hip fracture (N=162): 80 in the intervention group and 82 in the usual care control group.


METHODS
An interdisciplinary program of geriatric consultation, continuous rehabilitation, and discharge planning.


METHODS
Outcomes (clinical outcomes, self-care ability, health-related quality of life (HRQoL), service utilization, and depressive symptoms) were assessed 1, 3, 6, 12, 18, and 24 months after discharge. Self-care ability (ability to perform activities of daily living (ADLs)) was measured using the Chinese Barthel Index. HRQoL was measured using the Medical Outcomes Study 36-item Short Form Survey, Taiwan version (SF-36). Depressive symptoms were measured using the Chinese Geriatric Depression Scale, short form.


RESULTS
Subjects in the intervention group had significantly better ratios of hip flexion (beta=5.43, P<.001), better performance on ADLs (beta=9.22, P<.001), better recovery of walking ability (odds ratio (OR)=2.23, P<.001), fewer falls (OR=0.56, P=.03), fewer depressive symptoms (beta=-1.31, P=.005), and better SF-36 physical summary scores (beta=6.08, P<.001) than the control group during the first 24 months after discharge. The intervention did not affect the peak force of the fractured limb's quadriceps, mortality, service utilization, or SF-36 mental summary score.


CONCLUSIONS
The interdisciplinary intervention for hip fracture benefited elderly persons with hip fracture by improving clinical outcomes, self-care ability, and physical health-related outcomes and by decreasing depressive symptoms during the first 24 months after hospital discharge.
Shyu
Yea-Ing L
YI
School of Nursing, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Taoyuan 333, Taiwan. yeaing@mail.cgu.edu.tw
Liang
Jersey
J
Wu
Chi-Chuan
CC
Su
Juin-Yih
JY
Cheng
Huey-Shinn
HS
Chou
Shih-Wei
SW
Chen
Min-Chi
MC
Yang
Ching-Tzu
CT
Tseng
Ming-Yueh
MY
D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003863:Depression / Q000453:epidemiology; D005260:Female; D015577:Geriatric Assessment; D006620:Hip Fractures / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome