Risk factors for failure to return to the pre-fracture place of residence after hip fracture: a prospective longitudinal study of 444 patients.
BACKGROUND
Long-term place of residence after hip fracture is not often described in literature. The goal of this study was to identify risk factors, known at admission, for failure to return to the pre-fracture place of residence of hip fracture patients in the first year after a hip fracture.


METHODS
This is a prospective longitudinal study of 444 consecutive admissions of hip fracture patients aged ≥ 65 years. Place of residence prior to admission, at discharge, after 3 and 12 months was registered. Patients admitted from a nursing home (n = 49) were excluded from statistical analysis. Multivariable logistic regression analysis was performed, using age, gender, presence of a partner, ASA-score, dementia, anaemia at admission, type of fracture, pre-fracture level of mobility and level of activities of daily living (ADL) as possible risk factors.


RESULTS
Two hundred eighty-nine patients lived in their own home, 31.8% returned at discharge, 72.9% at 3 months and 72.8% at 12 months. Age, absence of a partner, dementia, and a lower pre-fracture level of ADL or mobility were independent contributors to failure to return to their own home at discharge, 3 or 12 months. 106 patients lived in a residential home; 33.3% returned at discharge, 68.4% at 3 months and 64.4% at 12 months. Age was an independent contributor to failure to return to a residential home.


CONCLUSIONS
Age, dementia and a lower pre-fracture level of ADL were the main significant risk factors for failure to return to the pre-fracture residence. As the 3- and 12-month return-rates were similar, 3-month follow-up might be used as an endpoint in future research.
Department of Orthopaedic Surgery, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands. ajhvochteloo@hotmail.com
Anne J H
AJ
Vochteloo
Sabine T
ST
van Vliet-Koppert
Andrea B
AB
Maier
Wim E
WE
Tuinebreijer
Maarten L
ML
Röling
Mark R
MR
de Vries
Rolf M
RM
Bloem
Rob G H H
RG
Nelissen
Peter
P
Pilot
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003704:Dementia / Q000150:complications; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011446:Prospective Studies; D012111:Residence Characteristics; D012307:Risk Factors