title: Factors influencing the progress of mobilization in hip fracture patients during the early postsurgical period?-A prospective observational study.
abstract: OBJECTIVE
  The aim of the present study was to determine the independent factors influencing mobilization progress after geriatric hip fractures.
  
  
  METHODS
  392 Hip fracture patients older than 60 years were included in this prospective, observational, cohort study. The progress of mobilization was measured with walking ability 4 days post-surgery, ability to climb stairs until discharge and the Tinetti test at discharge. Factors correlated with the progress of mobilization were determined using multivariate analyses.
  
  
  RESULTS
  The independent factors influencing walking ability 4 days post-surgery were the pre-fracture Charlson Comorbidity Index (OR=0.834, p=0.005), the American Society of Anesthesiologists Score (OR=0.550, p=0.013), pre-fracture Barthel Index ([BI], OR=1.019, p=0.012) and risk for depression, as measured by the Geriatric Depression Scale, (OR=0.896, p=0.013). The probability of climbing stairs until discharge was influenced by the patient's age (OR=0.840, p<0.001), pre-fracture BI (OR=1.047, p=0.042), cognitive impairment, as measured by the mini mental state examination (OR=1.182 p=0.008), pre surgical hemoglobin (OR=1.026, p=0.044), time until surgery (OR=0.961, p=0.023), duration of surgery (OR=0.982, p=0.014), and surgery type (prosthesis, OR=4.545, p=0.001). Similar variables influenced the Tinetti test ad discharge.
  
  
  CONCLUSIONS
  While pre-fracture co-morbidities and function cannot be changed, the treatment of patients with cognitive impairment and depressive symptoms should be optimized. Efforts should be undertaken to ensure early surgery for all hip fractures.
authors: Department of Trauma, Hand and Reconstructive Surgery, Philipps-University of Marburg, Marburg, Germany. Electronic address: buecking@med.uni-marburg.de.
authors: Benjamin
authors: B
authors: Buecking
authors: Department of Neurology, Philipps-University of Marburg, Marburg, Germany.
authors: Katharina
authors: K
authors: Bohl
authors: Department of Trauma, Hand and Reconstructive Surgery, Philipps-University of Marburg, Marburg, Germany.
authors: Daphne
authors: D
authors: Eschbach
authors: Department of Trauma, Hand and Reconstructive Surgery, Philipps-University of Marburg, Marburg, Germany.
authors: Christopher
authors: C
authors: Bliemel
authors: Department of Trauma, Hand and Reconstructive Surgery, Philipps-University of Marburg, Marburg, Germany.
authors: Rene
authors: R
authors: Aigner
authors: Department of Neurology, Philipps-University of Marburg, Marburg, Germany.
authors: Monika
authors: M
authors: Balzer-Geldsetzer
authors: Department of Neurology, Philipps-University of Marburg, Marburg, Germany.
authors: Richard
authors: R
authors: Dodel
authors: Department of Trauma, Hand and Reconstructive Surgery, Philipps-University of Marburg, Marburg, Germany.
authors: Steffen
authors: S
authors: Ruchholtz
authors: Department of Trauma, Hand and Reconstructive Surgery, Philipps-University of Marburg, Marburg, Germany.
authors: Florian
authors: F
authors: Debus
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation; D015577:Geriatric Assessment / Q000379:methods*; D006620:Hip Fractures / Q000534:rehabilitation* / Q000601:surgery; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities; D011182:Postoperative Care / Q000379:methods*; D011446:Prospective Studies; D013997:Time Factors; D016138:Walking / Q000502:physiology*
keywords: Fragility fracture; Geriatric fracture; Hip fracture; Mobilization; Rehabilitation