Time to Ambulation after Hip Fracture Surgery: Relation to Hospitalization Outcomes

Abstract

Objective. To test the hypothesis: Time to ambulation (walking) after hip fracture surgery impacts the frequency of postoperative complications and length of hospital stay. Methods. A retrospective observational study of a cohort of all patients admitted to a university teaching hospital with a principal International Classification of Diseases-9 diagnosis of a hip fracture during 3 calendar years. Results. A total of 131 participants were identified (68% were aged 65 years or older). Overall, the mean time to writing an order to ambulate a patient after a hip fracture surgery was 2 ± 1.5 days. Time to ambulation after hip fracture surgery was significantly less in patients cared for on orthopedic surgery service compared to general surgery service (1.8 ± 1 vs 2.5 ± 2, p < .05) or general internal medicine service (2.5 ± 1.5, p < .001), and to prolonged length of hospital stay (B [slope coefficient] = 1.36, p < .0001) but not to the development of pressure ulcers, deep venous thrombosis, or urinary tract infection. Conclusions. Delayed ambulation after hip fracture surgery is related to the development of new onset delirium and pneumonia postoperatively as well as to increased length of hospital stay. Early ambulation after hip fracture surgery should be encouraged.