title: Atrial fibrillation is not associated with rehabilitation outcomes of elderly hip fracture patients.
abstract: OBJECTIVE
  To study possible differences in rehabilitation outcomes of patients with hip fracture, with and without atrial fibrillation.
  
  
  METHODS
  A retrospective cohort study comprising 1114 patients, divided into three groups: patients with sinus rhythm, paroxysmal atrial fibrillation or chronic atrial fibrillation. All patients underwent a standard orthogeriatric care comprising surgical hip repair and a rehabilitation course. Main outcome measures included functional status at discharge by the Functional Independence Measure, post-fracture functional status category and type of postdischarge living arrangement.
  
  
  RESULTS
  Patients with atrial fibrillation differed from patients in sinus rhythm by female sex (P = 0.018), older age (P = 0.008) and higher rates of heart failure (P < 0.001), ischemic heart disease (P < 0.001), previous stroke (P < 0.001), and American Society of Anesthesiologists score (P < 0.001). No differences were observed among the three groups regarding Functional Independence Measure motor and total scores. In regression analysis, Mini-Mental State Examination (P < 0.001), prefracture status (P < 0.001), postsurgery motor Functional Independence Measure (P < 0.0001) and Parkinson's disease (P = 0.009) were predictive of higher motor Functional Independence Measure at discharge, whereas atrial fibrillation had no predictive value whatsoever. There were no differences among groups in magnitude of postfracture change of functional status category or type of postdischarge living arrangement.
  
  
  CONCLUSIONS
  Discharge motor Functional Independence Measure scores, postfracture changes in functional status and in discharge placement are similar in hip fracture patients with sinus rhythm, compared with those with atrial fibrillation. Atrial fibrillation should not be considered to adversely affect the rehabilitation outcome of these patients.
authors.affiliation: Department of Geriatric Medicine and Rehabilitation The Orthogeriatric Hip Fracture Unit, Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel. adunger1@sheba.health.gov.il
authors.forename: Abraham
authors.initials: A
authors.lastname: Adunsky
authors.forename: Marina
authors.initials: M
authors.lastname: Arad
authors.forename: Nira
authors.initials: N
authors.lastname: Koren-Morag
authors.forename: Yudit
authors.initials: Y
authors.lastname: Fleissig
authors.forename: Eliyahu Haim
authors.initials: EH
authors.lastname: Mizrahi
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001281:Atrial Fibrillation / Q000150:complications*; D016009:Chi-Square Distribution; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment; D006333:Heart Failure / Q000150:complications; D006620:Hip Fractures / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications; D012044:Regression Analysis; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications; D016896:Treatment Outcome