Article

OBJECTIVE: To investigate the relationship between orthostatic hypotension (OH)
and muscle strength versus time to successful rehabilitation within elderly
patients with hip fracture. DESIGN: A prospective, observational cohort study.
Handgrip strength was measured at the day of admission and OH as soon as possible
after surgery. Cox proportional hazard modeling was used to investigate the
relationship between OH or handgrip strength (kg) and time to successful
rehabilitation, expressed as hazard ratios (HRs). OH was defined as a decrease in
systolic blood pressure of >/=20mmHg or diastolic blood pressure of >/=10mmHg
after postural change (dichotomous). Handgrip strength was measured with a hand
dynamometer (continuous). SETTING: General hospital. PARTICIPANTS: Patients
(N=116) aged >/=70 years with a hip fracture were recruited on the day of
hospital admission. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Primary
outcome was time to successful rehabilitation, which was defined as discharge to
patients' own homes. RESULTS: During a median follow-up period of 36 days
(interquartile range, 9-57d), 103 patients (89%) were successfully rehabilitated.
No statistically significant relationships were found between OH and time to
successful rehabilitation (HR=1.05; 95% confidence interval [CI], .67-1.66).
Also, handgrip strength and successful rehabilitation were not statistically
significantly related (HR=1.03; 95% CI, .99-1.06). CONCLUSIONS: OH measured
during the first days of hospitalization is not related to time to successful
rehabilitation in patients with hip fracture who have undergone surgery. Although
no significant relationship was seen in the present study, the width of the CIs
does not exclude a relevant relationship between handgrip strength and time to
successful rehabilitation.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS