This study aimed to determine the use of the RMI in predicting functional recovery in elderly patients with HF in acute care hospitals within the first postoperative week.
This longitudinal retrospective observational study included all adult patients ≥65 years with HF who underwent surgery at our hospital from October 2022 to September 2024. Patients who died during hospitalization, underwent reoperation, had postoperative weight-bearing restrictions, were transferred from other hospitals, were unable to walk before fracture, or had missing data were excluded.
Physical therapists assessed the RMI at the initial assessment and on postoperative day 7 (POD7). The functional level was assessed with the motor Functional Independence Measure (mFIM), and functional recovery was calculated as the absolute mFIM gain (discharge mFIM minus initial assessment mFIM).
Patient information, including age, sex, fracture type, presence of dementia, pre-injury living situation, new mobility score, and postoperative complications, was obtained from clinical records.
The correlation between mFIM gain and RMI at both the initial assessment and POD7 was analyzed with Spearman’s rank correlation coefficient. Multiple regression analysis was conducted with mFIM gain as the dependent variable and RMI at either the initial assessment or POD7, along with other clinical factors (potential confounding factors), as independent variables.
P-values of 0.05 indicated significant differences and correlations.
This study included 284 patients who met the inclusion criteria out of the 357 patients. The patients’ mean age was 85.7 ± 6.3 years, and the majority were female (81.2%). Spearman’s rank correlation coefficients between mFIM gain and RMI were r of 0.33 (p 0.01) and 0.64 (p 0.01) at initial assessment and POD7, respectively. Multiple regression analysis adjusting the potential confounding factors revealed that RMI at the initial assessment was not significantly associated with mFIM gain (β = 0.96, p = 0.06), whereas RMI at POD7 was significantly associated with mFIM gain (β = 2.76, p 0.01) after adjustment.
The present results indicate that the RMI at POD7 is a useful measure for predicting functional recovery in elderly patients with HF in acute care hospitals.
The RMI at POD7 could be a prognostic tool for predicting functional recovery in elderly patients with HF in acute care hospitals, contributing to establishing realistic rehabilitation goals and facilitating discharge planning.
functional recovery
Rivermead Mobility Index
