Efficient predictors for the decline of activities of daily living in patients with hip fracture one year after surgery: A multicenter prospective cohort study

Article type: Research Article

Authors: Umehara, Takuya^{a; *} | Tanaka, Ryo^b | Nagao, Susumu^a | Tomiyama, Daisuke^a | Kawabata, Yuki^a | Nagano, Yoshihiro^c | Takeuchi, Yumi^c | Kakehashi, Masayuki^d

Affiliations: [a] Department of Rehabilitation, Saiseikai Kure Hospital, Hiroshima, Japan | [b] Graduate School of Integrated Arts and Sciences, Hiroshima University, Hiroshima, Japan | [c] Department of Rehabilitation, Saiseikai Hiroshima Hospital, Hiroshima, Japan | [d] Department of Health Informatics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

Correspondence: [*] Corresponding author: Takuya Umehara, Department of Rehabilitation, Saiseikai Kure Hospital, 2-1-13 Sanjo, Kure, Hiroshima 737-0821, Japan. Tel.: +81 823 21 1601; Fax: +81 823 21 1500; E-mail: start.ume0421@gmail.com.

Abstract: BACKGROUND: Previous studies have examined when activities of daily living (ADL) recovery more than six months after surgery can be predicted, and how much accuracy the predictors have. OBJECTIVE: The purpose of this study was to determine the predictors of ADL decline and evaluate their accuracies one year post-operation for hip-fracture patients. METHODS: We studied patients who underwent hip fracture surgery and were able to walk independently pre-operatively. The predictors of ADL declined one year post-operation, as analyzed using data of the basic medical attributes of the patients, including pain, 30-s chair-stand test, dementia [using the Revised Hasegawa Dementia Scale (HDS-R)], and walking/mobility style [using Barthel Index (BI)]. Using a receiver operating curve (ROC) curve, the cut-off value for each significant predictor was determined in the logistic regression analysis. To calculate the cut-off values and diagnostic performances of each of the extraction factors. RESULTS: The data of 36 patients were collected over a period of one year. The prior probability of ADL decline at one year post-operation was 44.4%. The results of logistic regression analyses showed that the score of HDS-R at admission and the walking/mobility BI score at three weeks post-operation were significant predictors of the one year post-operative decline in ADL. The results of the ROC analyses showed that the cut-off value of the HDS-R score at admission was < 23 points. The posterior probability increased to 62.0%. In contrast, the cut-off value of the walking/mobility BI score was 0 points. The posterior probability increased to 91.0%. CONCLUSION: The ADL decline of the patients who underwent hip fracture surgery at one year after surgery can be predicted at three weeks post-operation.

Keywords: Hip fracture, one year post-operation, ADL, surgery

DOI: 10.3233/BMR-181126

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 553-560, 2020