Article

OBJECTIVE: To identify factors associated with preserved walking ability and Katz
activities of daily living (ADLs) index at 4-month and 12-month follow-up in
cognitively impaired patients with femoral neck fracture. DESIGN:
Population-based cohort study. SETTING: A multicenter study of the Stockholm Hip
Fracture Group including 4 university hospitals. PARTICIPANTS: Consecutive
patients (N=246) with femoral neck fracture, older than 65 years (mean, 84y; 72%
women) with cognitive impairment (known dementia or low [0-2 points] score) in
Short Portable Mental Status Questionnaire [0-10 points]) and able to walk before
the fracture. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Walking
ability and ADLs index at 4-month and 12-month follow-up. RESULTS: Significant
predictors of preserved walking ability at 12-month follow-up were discharge to
rehabilitation unit (odds ratio [OR]=2.83; confidence interval [CI], 1.1-7.26;
P=.03) and walking ability before the fracture (OR=8.98; CI,
3.52-22.93; P<.001),
while type of surgery was not (P=.197). Analyses were adjusted for age, sex,
American Society of Anesthesiologists score, fracture type, and surgical method.
Corresponding predictors of preserved Katz ADLs index at 12-month follow-up,
after adjustment for age and sex, were discharge to rehabilitation unit (OR=5.33;
CI, 1.44-19.65; P=.012) and ADLs index before fracture (OR=2.51; CI, 1.8-3.5;
P<.001), while type of surgery was not (P=.376). CONCLUSIONS: Discharge to
rehabilitation unit, a factor we can influence, was associated with preserved
walking ability and ADLs index in cognitively impaired patients with hip fracture.
CI - Copyright (c) 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS