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Characteristics and Outcomes of Patients in Rehabilitation with Hip Fracture: A Retrospective Chart Review

Published online by Cambridge University Press:  09 July 2018

Erica Anders ,
Wendy Laskey ,
Catherine Milne-Gibson ,
Brendan Pynenburg ,
Chelsea Wong ,
Anna Berall ,
Nancy Jones ,
Debbie Mendelson  and
Susan Jaglal
Erica Anders*
Affiliation:
Department of Physical Therapy, University of Toronto
Wendy Laskey
Affiliation:
Department of Physical Therapy, University of Toronto
Catherine Milne-Gibson
Affiliation:
Department of Physical Therapy, University of Toronto
Brendan Pynenburg
Affiliation:
Department of Physical Therapy, University of Toronto
Chelsea Wong
Affiliation:
Department of Physical Therapy, University of Toronto
Anna Berall
Affiliation:
Baycrest Health Sciences, Toronto
Nancy Jones
Affiliation:
Lakeridge Health Oshawa
Debbie Mendelson
Affiliation:
Baycrest Health Sciences, Toronto
Susan Jaglal
Affiliation:
Department of Physical Therapy, University of Toronto
*
†La correspondance et les demandes de tirés-à-part doivent être adressées à : / Correspondence and requests for offprints should be sent to: Erica Anders, MScPT Department of Physical Therapy University of Toronto 160-500 University Ave Toronto ON M5G 1V7 <erica.anders@mail.utoronto.ca>
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Abstract

Hip fracture rehabilitation has two streams: high tolerance short duration (HTSD) and low tolerance long duration (LTLD). This study examined patient characteristics and outcomes in HTSD and LTLD associated with length of stay (LOS) and discharge destination. We retrospectively examined patients’ medical charts following hip fracture surgery and collected demographic, functional, and health characteristics. A statistical analysis was done to describe the differences between HTSD (n = 73) and LTLD (n = 57) patient characteristics and their relationship with LOS and discharge destination. Those in LTLD were significantly older, less independent with prefracture bathing and instrumental activities of daily living, had lower Functional Independence Measure (FIM) admission scores, and more co-morbidities. Higher FIM motor score on admission in HTSD and greater change in FIM total score in LTLD was significantly correlated with discharge home. Diabetes in LTLD and lower total admission FIM in HTSD was significantly associated with increased LOS.

Résumé

Deux voies de réadaptation sont utilisées dans les cas de fractures de la hanche : la voie de courte durée avec tolérance élevée (CDTÉ) et celle de longue durée avec basse tolérance (LDBT). Cette étude a examiné les caractéristiques et les résultats de patients en CDTÉ et LDBT qui étaient associés avec la durée du séjour à l’hôpital (DSH) et la destination après le congé de l’hôpital (DC). Un examen rétrospectif des dossiers médicaux des patients opérés pour une fracture de la hanche a été réalisé après leur chirurgie. Les données démographiques, fonctionnelles et liées à la santé de ces patients ont été collectées. Des analyses statistiques ont été effectuées afin d’évaluer les différences entre les caractéristiques des patients en CDTÉ (n = 73) et en LDBT (n = 57), et leurs liens avec leur DSH et DC. Les patients en LDBT étaient plus âgés et leur niveau d’autonomie pré-fracture pour le bain et les activités instrumentales de la vie quotidienne était plus faible. Les résultats de ces patients pour la Mesure de l’indépendance fonctionnelle (MIF) à l’admission étaient aussi plus faibles, et leur taux de comorbidités, plus élevé. Des scores MIF plus élevés à l’admission pour les patients en CDTÉ et une évolution plus marquée des scores MIF pour les patients LDBT étaient associés à la destination « maison » après le congé de l’hôpital. Le taux de diabète chez les patients en LDBT et un score MIF plus faible étaient liés à une DSH plus longue.

Keywords

aginghip fracturelow tolerance long duration rehabilitationhigh tolerance short duration rehabilitationlength of staydischarge destinationvieillissementfracture de la hancheréadaptation de longue durée avec faible toléranceréadaptation de courte durée avec forte tolérancedurée de séjourdestination suivant le congé de l’hôpital
Type
Article
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 37 , Issue 3 , September 2018 , pp. 270 - 280
Copyright
Copyright © Canadian Association on Gerontology 2018 

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Footnotes

*

The authors acknowledge Jurgis Karuza for his assistance in this research. This research was completed in partial fulfillment of the requirements for an MScPT degree at the University of Toronto.

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