Article

OBJECTIVES: To develop and assess a clinical prediction rule (CPR) to predict
declines in activities of daily living (ADL) at 6 months after surgery for hip
fracture repair. DESIGN: Prospective, cohort study. SETTING: From hospital to
home. PARTICIPANTS: Patients (N=104) with hip fractures after surgery.
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE:
ADL were assessed using the
Barthel Index at 6 months after surgery. RESULTS: At 6 months after surgery, 86
patients (82.6%) were known to be alive, 1 patient (1.0%) had died, and 17
(16.3%) were lost to follow-up. Thirty-two patients (37.2%) did not recover their
ADL at 6 months after surgery to levels before fracture. The classification and
regression trees methodology was used to develop 2 models to predict a decline in
ADL: (1) model 1 included age, type of fracture, and care level before fracture
(sensitivity=75.0%, specificity=81.5%, positive predictive value=70.6%, positive
likelihood ratio=4.050); and (2) model 2 included the degree of independence 2
weeks postsurgery for ADL chair transfer, ADL ambulation, and age
(sensitivity=65.6%, specificity=87.0%, positive predictive value=75.0%, positive
likelihood ratio=5.063). The areas under the receiver operating characteristic
curves of both CPR models were .825 (95% confidential interval, .728-.923) and
.790 (95% confidence interval, .683-.897), respectively. CONCLUSIONS: CPRs with
moderate accuracy were developed to predict declines in ADL at 6 months after
surgery for hip fracture repair.
CI - Copyright A(c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS