Determinants of Lack of Recovery from Dependency and Walking Ability Six Months after Hip Fracture in a Population of People Aged 65 Years and Over

Abstract

Background: Hip fracture in the elderly means that between a quarter and a half of patients do not regain the levels of independence and walking ability that they previously had, according to the literature, after the fracture. Material and methods: Retrospective study of 537 patients aged ≥65 years who survived at the sixth month after fracturing their hip, of which the age, sex, type of fracture, surgical risk, independence (BI), walking ability, cognitive level (PS), comorbidities, indicated drugs, complications, surgical delay, hospital stay, and surgical technique are known. Using Pearson’s χ2 test, all the variables were contrasted with respect to the limitation or not, at the sixth month of the recovery of both independence and pre-admission walking ability. Multivariate analysis provides the necessary adjustment to the previous contrast. Results: We have found that age and PS ≥ 5 at admission limit recovery from both dependency and walking ability. Surgical risk, independence (BI) upon admission, anemia, and constipation during the hospital stay limit the recovery of the BI. Worsening of walking ability during the hospital stay and the type of extra-articular fracture, which was surgically treated by osteosynthesis, limit the recovery of walking ability. Conclusions: The factors previously exposed, and perhaps the fact that patients with hip fractures are not routinely referred to rehabilitation, explain the high proportion of patients who do not recover their previous independency (36%) or walking ability (45%) to the fact of fracturing.