title: Review of the long-term disability associated with hip fractures.
abstract: OBJECTIVE
  To determine the proportion of hip fracture patients who experience long-term disability and to re-estimate the resulting burden of disease associated with hip fractures in Australia in 2003.
  
  
  METHODS
  A literature review of the functional outcome following a hip fracture (keywords: morbidity, treatment outcome, disability, quality of life, recovery of function, hip fractures, and femoral neck fractures) was carried out using PubMed and Ovid MEDLINE.
  
  
  RESULTS
  A range of scales and outcome measures are used to evaluate recovery following a hip fracture. Based on the available evidence on restrictions in activities of daily living, 29% of hip fracture cases in the elderly do not reach their pre-fracture levels 1 year post-fracture. Those who do recover tend to reach their pre-fracture levels of functioning at around 6 months. These new assumptions result in 8251 years lived with disability for hip fractures in Australia in 2003, a 4.5-fold increase compared with the previous calculation based on Global Burden of Disease assumptions that only 5% of hip fractures lead to long-term disability and that the duration of short-term disability is just 51 days.
  
  
  CONCLUSIONS
  The original assumptions used in burden of disease studies grossly underestimate the long-term disability from hip fractures. The long-term consequences of other injuries may similarly have been underestimated and need to be re-examined. This has important implications for modelling the cost-effectiveness of preventive interventions where disability-adjusted life years are used as a measure of health outcome.
authors.affiliation: The University of Queensland, Centre for Burden of Disease & Cost Effectiveness, School of Population Health, Brisbane, Australia.
authors.forename: Melanie
authors.initials: M
authors.lastname: Bertram
authors.forename: Rosana
authors.initials: R
authors.lastname: Norman
authors.forename: Linda
authors.initials: L
authors.lastname: Kemp
authors.forename: Theo
authors.initials: T
authors.lastname: Vos
mesh_terms: D000203:Activities of Daily Living; D001315:Australia; D017281:Cost of Illness; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006620:Hip Fractures / Q000503:physiopathology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019057:Quality-Adjusted Life Years; D020127:Recovery of Function; D016896:Treatment Outcome