The basic mobility status upon acute hospital discharge is an independent risk factor for mortality up to 5 years after hip fracture surgery: Survival rates of 444 pre-fracture ambulatory patients evaluated with the Cumulated Ambulation Score

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Background and purpose — Mortality rates following hip fracture (HF) surgery are high. We evaluated the influence of the basic mobility status on acute hospital discharge to 1- and 5-year mortality rates after HF. Patients and methods — 444 patients with HF ≥60 years (mean age 81 years, 77% women) being pre-fracture ambulatory and admitted from their own homes, were consecutively included in an in-hospital enhanced recovery program and followed for 5 years. The Cumulated Ambulation Score (CAS, 0–6 points, 6 points equals independence) was used to evaluate the basic mobility status on hospital discharge. Results — 102 patients with a CAS <6 stayed in the acute ward a median of 22 (15–32) days post-surgery as compared with a median of 12 (8–16) days for those 342 patients who achieved a CAS =6. Overall 1-year mortality was 16%; in those with CAS <6 it was 30% and in those with CAS =6 it was 12%. Corresponding data for 5-year deaths were 78% and 50%. Multivariable Cox regression analysis demonstrated that the likelihood of not surviving the first 5 years after hip fracture was 1.5 times higher for those with a CAS <6 and for men; 2 times higher for those 80 years or older; increased by 50% per point higher ASA grade; and was reduced by 11% per point higher New Mobility Score, when adjusted for the cognitive and fracture type status. Interpretation — Further studies focused on interventions that improve the basic mobility status of patients with HF should be instigated within the early time period following surgery.
Original languageEnglish
JournalActa Orthopaedica
Volume89
Issue number1
Pages (from-to)47-52
ISSN1745-3674
DOIs
Publication statusPublished - 2018

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