title: The Trochanteric Localization is a Mediator of Slower Short-Term Functional Recovery in Overweight and Obese Elderly Women with Recent Hip Fracture: The BREAK Study.
abstract: The hypothesis tested in this study, carried out on elderly Italian women with recent hip fracture, was to assess the extent to which the effect of a condition of being overweight/obese on short-term functional recovery as evaluated by the "time to permitted load" could be explained by a mediator variable (type of hip fracture). We studied 727 women aged 60 years or over with a recent low trauma surgically treated hip fracture and for whom an information on post-surgery complications and on the time to permitted load was available. To assess for mediation, the statistical analyses were carried out following the procedure described by Baron and Kenny. In this study, 46 % of women with hip fracture presented a time to permitted load of ≥ 10 days. The women with a post-surgery time to permitted load of ≥ 10 days showed a significantly higher proportion of trochanteric fracture localization (72.1 vs 42 %), of total overweight/obesity (46.5 vs 36.8 %) and of post-surgery complications (38.8 vs 18.8 %). The mediating effect of hip fracture localization on the association between overweight/obesity and the time of permitted load was demonstrated and confirmed in a multivariate logistic regression model. This study, carried out using a "mediator" statistical analysis, suggests that in elderly women with hip fracture being overweight/obese is associated with a slower short-term functional recovery as evaluated by the time to permitted load and that this association is mediated by the trochanteric localization of hip fracture.
authors.affiliation: Department of Medicine, Surgery and Neurosciences, University of Siena, Policlinico Le Scotte, Viale Bracci 2, 53100, Siena, Italy. gonnelli@unisi.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Gonnelli
authors.affiliation: Department of Medicine, Surgery and Neurosciences, University of Siena, Policlinico Le Scotte, Viale Bracci 2, 53100, Siena, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Caffarelli
authors.affiliation: Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Rossi
authors.affiliation: CNR Aging Branch, Institute of Neuroscience, Padua, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Siviero
authors.affiliation: CNR Aging Branch, Institute of Neuroscience, Padua, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Maggi
authors.affiliation: CNR Aging Branch, Institute of Neuroscience, Padua, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Crepaldi
authors.affiliation: Department of Medicine, Surgery and Neurosciences, University of Siena, Policlinico Le Scotte, Viale Bracci 2, 53100, Siena, Italy.
authors.forename: Ranuccio
authors.initials: R
authors.lastname: Nuti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006620:Hip Fractures / Q000150:complications* / Q000473:pathology*; D006801:Humans; D007558:Italy; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D020127:Recovery of Function; D013997:Time Factors
keywords: Hip fracture; Mediation analysis; Obesity; Overweight; Permitted load; Trochanteric fracture