title: Long-term functional outcome in geriatric hip fracture patients.
abstract: BACKGROUND
  Fragility fractures are a major health care problem worldwide. The proportion of the geriatric population and the overall life expectancy will increase. Hip fractures are the most common fragility fractures needing surgery and nowadays treatment concepts are changing. We studied the long-term functional outcome and their influencing factors in patients treated without any interdisciplinary aspects.
  
  
  METHODS
  A retrospective cohort study with functional long-term follow-up examination was carried out in a level one trauma centre on hip fracture patients 80 years old and above treated without any formalized interdisciplinary aspects ("usual care").
  
  
  METHODS
  Of 281 consecutive patients who were treated 2005 and 2006 with usual care, 246 patients with a mean age of 86.8 years met our inclusion criteria. 69.1% died within the study period of 4.9 years. On the remaining patients, the residential status, the Barthel Index and the Parker Score were assessed.
  
  
  RESULTS
  The mean Barthel Index was 49.6 and the mean Parker Score was 2.7. More than one-fourth of the survivors were found to be bedridden and 45% were not able to walk outside. 88% are bound to one floor and only 8% are able to walk unaided. Patients with more comorbidities and patients with subsequent fractures had significant higher mortality rates. Patients with trochanteric fractures had significant better functional outcome scores compared to patients with femoral neck fractures. Nursing home residents showed significant higher mortality rates and lower functional outcome scores. Patients who were transferred to a nearby acute geriatric hospital for further treatment had significantly higher functional outcome scores.
  
  
  CONCLUSIONS
  This paper shows the frustrating long-term outcome of geriatric hip fracture patients but it also suggests that an early geriatric intervention may lead to better function.
authors.affiliation: Department of Trauma Surgery and Sportsmedicine, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. christian.kammerlander@uki.at
authors.forename: Christian
authors.initials: C
authors.lastname: Kammerlander
authors.forename: Markus
authors.initials: M
authors.lastname: Gosch
authors.forename: Ursula
authors.initials: U
authors.lastname: Kammerlander-Knauer
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Luger
authors.forename: Michael
authors.initials: M
authors.lastname: Blauth
authors.forename: Tobias
authors.initials: T
authors.lastname: Roth
mesh_terms: D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods; D001858:Bone Nails; D001863:Bone Screws; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D016330:Frail Elderly; D006620:Hip Fractures / Q000150:complications / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D020127:Recovery of Function; D012044:Regression Analysis; D012189:Retrospective Studies; D018709:Statistics, Nonparametric