Assessing the Relationship Between Cognition, Premorbid Function and Functional Outcomes After Hip Fracture Surgery

Abstract

Background/Purpose: Elderly who sustain hip fractures exhibit significant morbidity and mortality. Due to the aging population, the healthcare burden from hip fractures in Singapore is expected to increase significantly. Rehabilitation after hip fracture surgery is an integral component of hip fracture management with a multitude of factors influencing outcomes. Methods: A retrospective cohort study of all elderly patients above 60 admitted for rehabilitation to a local Community Hospital after hip fracture surgery over 1 year. Variables including demographics, premorbid function, post-operative weight bearing status, complications, comorbidities, admission cognitive status (Abbreviated Mental Test) were collected. Functional outcomes measured include Modified Barthel Index (MBI) gain and MBI efficiency. Scores for MBI were measured at admission and before discharge. Results: Patients with better cognitive status (AMT score ≥7) had better rehabilitation outcomes as measured by both MBI gain as well as MBI efficiency p <0.001). Patients that had a better premorbid functional status also had a better rehabilitation outcomes (p <0.001). Conclusion: Cognitive level and premorbid function were both closely associated with functional recovery after surgical repair of hip fracture.