Ohoka T.1,2, Urabe Y.2, Maeda N.2, Shima T.1, Shirakawa T.3
1Matterhorn Rehabilitation Hospital, Department of Rehabilitation, Kure, Japan, 2Hiroshima University, Graduate School of Biomedical & Health Sciences, Hiroshima, Japan, 3Matterhorn Rehabilitation Hospital, Department of Orthopedics, Kure, Japan
Background: With the emergence of the super elderly population in Japan, opportunities for postoperative physical therapy have increased at our hospital for patients aged 85years or older than 90 years (oldest old) with proximal femoral fracture.
The patient discharge destination with proximal femoral fracture and body function improvement have been reported, but reports on the oldest old remain little.
The patient discharge destination with proximal femoral fracture and body function improvement have been reported, but reports on the oldest old remain little.
Purpose: To determine whether a significant difference existed in body function improvement and the time to discharge destination when comparing women older than 90 years with other older age groups, in order to implement effective physical therapy.
Methods: The subjects were 101 women, aged ≥80 years, with proximal femoral fracture, who were hospitalized after surgery, from June 1, 2014 to August 1, 2016. The subjects were divided into 3 age groups: 8084 years (n=30), 8589 years (n=37), and ≥90 years (n=34). The study measures were discharge destination, age, height, weight, revised Hasegawa dementia scale (HDS-R), hospitalization, 10-m walking time, isometric knee extension muscular strength, and functional independence measurement (FIM) at admission and discharge destination. A one-way analysis of variance was used to compare the measurements of each group. The level of significance was set at p 0.05.
Results: The 8084 years group consisted of 26 homes (87%), 3 care facilities (10%), 1 changing hospital (3%), and 0 deaths. The 8589 years group consisted of 24 homes (65%), 12 care facilities (32%), 1 changing hospital (3%), and 0 deaths. The ≥90 years group consisted of 15 homes (44%), 14 care facilities (41%), 2 changing hospital (5%), and 3 deaths (9%).
FIM at admission in the 8084-years group was significantly higher compared with FIM at admission the 8589-years group and the ≥90-years group (p 0.05). Weight, 10-m walking time, isometric knee extension muscular strength and FIM at admission and discharge destination were significantly lower in the 8084 years group compared with the ≥90 years group (p 0.05).
Conclusion(s): The ≥90 years group was clearly low (44%), comparing the discharge destination-to-home rate of 8084 years group (87%). As a point of physical therapy for the ≥90 years group with proximal femoral fracture, the discharge destination-to-home rate might rise by improving the walking ability, lower limb muscle strength and activities of daily living.
Implications: This study is useful to predict the physical therapy goal and discharge destination in female patients ≥ 90 years of age with proximal femoral fracture.
Funding acknowledgements: This study was not funded by any organization that could influence the research results.
Topic: Older people
Ethics approval: Subjects and family participated in this study after signing an informed consent form approved by the institutional review board (MRH16003).
All authors, affiliations and abstracts have been published as submitted.
