More than half of hip fracture patients do not regain mobility in the first postoperative year.
OBJECTIVE
To measure functional recovery and determine risk factors for failure to return to the prefracture level of mobility of hip fracture patients 1 year postoperatively.


METHODS
A prospective cohort follow-up study of 390 hip fracture patients aged 65 years and older was carried out. Patients were stratified in categories based on prefracture mobility: mobile without aid, with aid in- and outdoors, or only mobile indoors. Immobile patients were excluded. Risk factors for not regaining prefracture mobility were identified.


RESULTS
Nearly half of all patients regained their prefracture level of mobility after 1 year. Mobile patients without an aid were less likely to return to their prefracture mobility level compared with patients who were mobile with aid or mobile indoors. After 1 year, 18.7% of all patients had become immobile. Most important independent risk factors for failure to return to the prefracture level of mobility were a limited prefracture level of activities of daily living and a delirium during admission.


CONCLUSIONS
The risk not to regain prefracture mobility is highest in mobile patients without an aid. The risk of becoming immobile is higher in those having a lower prefracture mobility. Activities of daily living dependence and delirium were the main risk factors for not regaining mobility.
Department of Orthopedics, Leiden University Medical Center, Leiden, the Netherlands. ajhvochteloo@hotmail.com
Anne J H
AJ
Vochteloo
Sophie
S
Moerman
Wim E
WE
Tuinebreijer
Andrea B
AB
Maier
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; D000740:Anemia / Q000150:complications; D002183:Canes; D015331:Cohort Studies; D003446:Crutches; D003693:Delirium / Q000150:complications; D003704:Dementia / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D007326:Institutionalization; D008297:Male; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology*; D012307:Risk Factors; D012737:Sex Factors; D015996:Survival Rate; D014853:Walkers; D016138:Walking / Q000502:physiology*; D014910:Wheelchairs