The burden of prevalent vertebral fractures is negatively associated with functional outcome in women with hip fracture.

OBJECTIVE

The aim of this study was to investigate the association between the burden of prevalent vertebral fractures and functional outcome in women with hip fracture.

DESIGN

We investigated 164 of 180 women with hip fracture admitted consecutively to a rehabilitation hospital. Lateral radiographs of the spine were taken 20.0 ± 5.1 days (mean ± SD) after fracture occurrence. To obtain a summary measure of vertebral fracture burden, we calculated the spinal deformity index by summing the fracture grades of all vertebrae (T4 to L4), assessed using Genant's method. Functional outcome was assessed using Barthel index scores.

RESULTS

In a Spearman rank test, we observed a significant negative correlation between spinal deformity index scores and Barthel index scores at discharge from rehabilitation (ρ = -0.23; P = 0.003). The association between spinal deformity index and Barthel index scores was confirmed (P = 0.039) after adjustment for eight potential confounders. Multiple regression also showed a significant negative association between spinal deformity index scores and increase in Barthel index scores during rehabilitation (P = 0.012). The panel of prognostic factors that we included in the multivariate analysis accounted for 62% of the variance in the Barthel index scores at discharge from rehabilitation and 43% of their increase during rehabilitation.

CONCLUSIONS

The burden of prevalent vertebral fractures is negatively associated with functional outcome in women with hip fracture.