Functional recovery of older hip-fracture patients after interdisciplinary intervention follows three distinct trajectories

Abstract

PurposeTo assess the effects of an interdisciplinary intervention on the trajectories of functional recovery among older patients with hip fracture during 2 years after hospitalization.Design and MethodsIn a randomized controlled trial with 24-month follow-up, 162 patients >60 years were enrolled after hip-fracture surgery at a 3,000-bed medical center in northern Taiwan. Patients received an interdisciplinary program of geriatric consultation, in-hospital and at-home rehabilitation, and discharge planning (n = 80) or usual care (n = 82). Patients' functional status was assessed by the Chinese Barthel Index before discharge and at 1, 3, 6, 12, 18, and 24 months after discharge. Covariates included demographic attributes, depressive symptoms, and cognitive functioning. Latent class growth modeling was used to examine distinctive groups of individual trajectories within the sample.ResultsFunctional recovery followed 3 distinct paths, approximated by either a quadratic or cubic function over time. These paths were (a) poor recovery (6.8%), (b) moderate recovery (47.5%), and (c) excellent recovery (45.7%). The interdisciplinary intervention significantly reduced the likelihood of poor recovery (relative risk ratio [RRR] = 0.05, p