title: Routine functional assessment for hip fracture patients.
abstract: Background and purpose - Pre-fracture functional level has been shown to be a consistent predictor of rehabilitation outcomes in older hip fracture patients. We validated 4 overall pre-fracture functional level assessment instruments in patients aged 65 or more, used the prediction of outcome at 4 months post-fracture, and assessed cutoff values for decision making in treatment and rehabilitation. Patients and methods - 165 consecutive patients with acute primary hip fracture were prospectively included in the study. Pre-fracture Barthel-20, Barthel-100, cumulated ambulation score, and new mobility score were scored immediately after admission. Outcome defined as mortality, residential status, and independent walking ability was assessed at 4 months. Results - 3 of the assessment instruments, namely Barthel-20, Barthel-100, and new mobility score, correlated with outcome at 4 months post-fracture and were valid predictors. Thresholds were estimated. We found no evidence that Barthel-100, with its finer granularity, performs better than Barthel-20 as a predictor. Interpretation - Our findings indicate that pre-fracture scores of Barthel-20 and new mobility score have predictive ability, and further investigation of usage for guidance of clinical and rehabilitation decisions concerning hip fracture patients is warranted.
authors.affiliation: a Rehabilitation Department , OUH Odense University Hospital, Svendborg Hospital ;|b Institute of Public Health, University of Southern Denmark ;
authors.forename: Tonny J
authors.initials: TJ
authors.lastname: Pedersen
authors.affiliation: c Orthopaedic Department , OUH Odense University Hospital ;|d Institute of Clinical Research, University of Southern Denmark , Odense , Denmark.
authors.forename: Jens M
authors.initials: JM
authors.lastname: Lauritsen
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006620:Hip Fractures / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function / Q000502:physiology*; D013997:Time Factors; D016896:Treatment Outcome