Pronostic factors of good functionality at 12 months of a hip fracture. Maluc Anoia study.

BACKGROUND

Hip fracture usually occurs in frail elderly patients and is associated with an important morbi-mortality in the first year. The objective of the study is to describe the prognostic factors that would allow maintaining functionality at 12 months.

METHOD

From June 1, 2010 to May 31, 2013, all patients older than 69 years with hip fracture due to bone fragility admitted to the Geriatric Acute Unit of our hospital were included. We define as functional maintenance those patients who have lost between 0-15 points in the Barthel Index with respect to the previous to the fracture. Prospective study of bivariate data analysis for related and multivariate prognostic factors for predictive predictors.

RESULTS

271 patients were included, of them, 146 (54.8%), maintained functionality at 12 months and 122 (45.2%) no. Patients who maintain functional status are younger: average age 83.4 vs 85.80 years (P=.002); with better scores in the indexes of: Lawton prior to fracture 4.42 vs 2.40 (P<.001) and Barthel at discharge 34.2 vs. 27.1 (P=.002). There are also differences in the score of the "Geriatric Dementia Scale" 2.59 vs. 3.13 (P=.009), in the score of the "American Society Anesthesiologist"<II 62.2% vs 37.8% (P=0.006) and have presented less delirium during hospitalization 4.7% vs 35.3% (P=.002). In the multivariate analysis they maintained statistical significance, age OR: 1.044 (95% CI: 1.002-1.088) (P=.04) and the Lawton Index OR: 0.869 (95% CI: 0.804-0.940) (P <.001).

CONCLUSIONS

Prognostic factors of functional maintenance at 12 months are age and the ability to perform instrumental activities of daily life.