title: Pre- and perioperative predictors of changes in mobility and living arrangements after hip fracture--a population-based study.
abstract: OBJECTIVE
  Examining pre- and perioperative predictors of changes in mobility and living arrangements after hip fracture.
  
  
  METHODS
  Population-based prospective data were collected on 1027 hip fracture patients aged ≥65. The outcomes were decreased vs. same or improved mobility level and need for more supported vs. same or less supported living arrangements 1 year after hip fracture. The independent variables were age, gender, body mass index, American Society of Anesthesiologists score, diagnosis of memory disorder, mobility level and living arrangements, fracture type, delay to surgery and urinary catheter removal during acute hospitalization.
  
  
  RESULTS
  Multivariate logistic regression analysis revealed the prefracture mobility level of walking outdoors (OR=0.47, 95% CI 0.30-0.75) or indoors (OR=0.25, 95% CI 0.09-0.72) assisted to be associated with a smaller decrease in mobility level. Non-independent mobility level (OR=2.74, 95% CI 1.70-4.41) was associated with the need of more supported living arrangements. Living in assisted living accommodations (OR=0.23, 95% CI 0.12-0.44) was associated with less need for more supported living arrangements. Removal of the urinary catheter showed a protective association on both decline in mobility level (OR=0.45; 95% CI 0.29-0.70) and moving to a more supported living arrangement(OR=0.49,95% CI 0.31-0.77.
  
  
  CONCLUSIONS
  Worsening of mobility was significant for independent mobilizers. Prefracture impaired mobility was associated with the need of more supported living arrangements. Living in an assisted living accommodation protected against institutionalization. The findings emphasize the importance of a prompt removal of the urinary catheter after hip fracture.
authors.affiliation: Department of Geriatric Medicine, Seinäjoki Central Hospital, Hanneksenrinne 7, 60220 Seinäjoki, Finland. Electronic address: hanna.pajulammi@fimnet.fi.
authors.forename: Hanna M
authors.initials: HM
authors.lastname: Pajulammi
authors.affiliation: Division of Orthopedics and Traumatology, Seinäjoki Central Hospital, Hanneksenrinne 7, 60220 Seinäjoki, Finland; University of Tampere, Mediwest, Koskenalantie 16, 60220 Seinäjoki, Finland.
authors.forename: Harri K
authors.initials: HK
authors.lastname: Pihlajamäki
authors.affiliation: Science Center, Pirkanmaa Hospital District, PL 2000, 33521 Tampere, Finland; School of Health Sciences, University of Tampere, 33014 University of Tampere, Finland.
authors.forename: Tiina H
authors.initials: TH
authors.lastname: Luukkaala
authors.affiliation: Department of Geriatric Medicine, Seinäjoki Central Hospital, Hanneksenrinne 7, 60220 Seinäjoki, Finland.
authors.forename: Maria S
authors.initials: MS
authors.lastname: Nuotio
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D005260:Female; D006620:Hip Fractures / Q000503:physiopathology* / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D007326:Institutionalization; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D059035:Perioperative Period; D026741:Physical Therapy Modalities; D011183:Postoperative Complications; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology*; D012307:Risk Factors; D016896:Treatment Outcome; D016138:Walking
keywords: Aged; Hip fracture; Living arrangements; Mobility level; Outcome; Population-based