Hip fractures in the elderly. Discharge predictions with a functional rating scale.

During a 12-month period, 44 (41%) of 108 patients (50 years of age or older) treated for hip fractures were discharged to a nursing home. One year after the fracture, 29 (66%) remained institutionalized, five (11%) had died, and ten (33%) had returned to their own homes. The discharge medical plan of care, completed by the surgeon, registered nurse, and a social worker, was correct in predicting temporary institutionalization in only 66% of the cases. In an attempt to provide a more accurate method of predicting the outcomes of hip-fracture patients, a functional rating scale was developed. The scale proved to be a valuable adjunct in identifying those patients who were predisposed to permanent institutionalization.