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Ogawa T1, Shirasawa S2
1Tokyo Medical and Dental University, Orthopaedics / Rehabilitation, Tokyo, Japan, 2Suwa Central Hospital, Department of Orthopaedics, Chino, Japan
Background: The hip fracture is a major problem of physical functional disability. Only a half of the hip fracture patient could recover their ambulatory function after surgery. As society ages, the burden of caregivers increases and it causes the scarcity of caregiving facilities such as hospital bed or nursing home. Therefore, the appropriate prediction of the functional recovery after hip fracture surgery is essential for the management of their living environment. Cumulated Ambulation Score (CAS) is a useful tool for the prediction of the length of hospital stay and mortality after surgery. However, it is unknown that the mobile functional recovery after surgery can be predicted with CAS, and the appropriate timing to measure and evaluate CAS.
Purpose: The aim of our research was to investigate
1) whether it is can predict that hip fracture patients recover after surgery according to assess, and we also evaluated CAS for nine days after surgery to evaluate
2) when the appropriate timing for evaluating CAS is.
Methods: In this retrospective study, we observed 174 elderly patients who underwent hip fracture surgery at a single hospital from 2013 to 2015. The primary outcome was to regain ambulatory function after surgery. We adjusted age, sex, comorbidity, the presence of dementia, preinjury ambulatory function, the length of hospital stay, implants we used for surgery, and waiting time for surgery. The ambulatory function was evaluated by CAS, with which it measured three movements, spine to sitting, sitting to standing, walking, and calculated scores. We measured CAS for postoperative day one to three, day four to six, day seven to nine, and we performed logistic regression analysis and evaluated each area under a curve (AUC) of CAS. The AUCs were compared to determine which one is most variable for predicting the outcome. We obtained ethical approval in the hospital committee.
Results: 96 out of 174 patients (55%) recovered ambulatory function after surgery. AUC of regaining ambulatory function was 0.89 (95% CI: 0.83-0.93) on postoperative day one to three, 089 (95% CI: 0.84-0.93) on postoperative day four to six, 0.91 (95% CI: 0.86-0.95) on postoperative day seven to nine.
Conclusion(s): It was possible to predict the physical recovery after hip fracture surgery by using CAS during each period. CAS on the postoperative day one to three is efficient enough to predict ambulatory recovery after surgery.
Implications: CAS can be a useful tool for predicting ambulatory recovery from the day after hip fracture surgery. It could be helpful to control bed vacancy.
Keywords: Hip Fracture, Cumulated Ambulation Score (CAS), walking ability
Funding acknowledgements: None
Purpose: The aim of our research was to investigate
1) whether it is can predict that hip fracture patients recover after surgery according to assess, and we also evaluated CAS for nine days after surgery to evaluate
2) when the appropriate timing for evaluating CAS is.
Methods: In this retrospective study, we observed 174 elderly patients who underwent hip fracture surgery at a single hospital from 2013 to 2015. The primary outcome was to regain ambulatory function after surgery. We adjusted age, sex, comorbidity, the presence of dementia, preinjury ambulatory function, the length of hospital stay, implants we used for surgery, and waiting time for surgery. The ambulatory function was evaluated by CAS, with which it measured three movements, spine to sitting, sitting to standing, walking, and calculated scores. We measured CAS for postoperative day one to three, day four to six, day seven to nine, and we performed logistic regression analysis and evaluated each area under a curve (AUC) of CAS. The AUCs were compared to determine which one is most variable for predicting the outcome. We obtained ethical approval in the hospital committee.
Results: 96 out of 174 patients (55%) recovered ambulatory function after surgery. AUC of regaining ambulatory function was 0.89 (95% CI: 0.83-0.93) on postoperative day one to three, 089 (95% CI: 0.84-0.93) on postoperative day four to six, 0.91 (95% CI: 0.86-0.95) on postoperative day seven to nine.
Conclusion(s): It was possible to predict the physical recovery after hip fracture surgery by using CAS during each period. CAS on the postoperative day one to three is efficient enough to predict ambulatory recovery after surgery.
Implications: CAS can be a useful tool for predicting ambulatory recovery from the day after hip fracture surgery. It could be helpful to control bed vacancy.
Keywords: Hip Fracture, Cumulated Ambulation Score (CAS), walking ability
Funding acknowledgements: None
Topic: Orthopaedics; Older people
Ethics approval required: Yes
Institution: Suwa central Hospital
Ethics committee: the Ethics Committee of the Suwa Central Hospital.
Ethics number: 281125
All authors, affiliations and abstracts have been published as submitted.
