Proposed Topic (Most preferred): :
Enhancing Partnership with Patients and Community (Projects initiated to engage patients / carers / community to improve efficiency / quality of care)
Authors (including presenting author) :
Chu CY (1), Chan Y (1) , Tan YK (1), Yip ST (1), Lui NF (1), Tiu KL (2), Lee KB (2), Li W (2), Li KK (2)
Affiliation :
(1) Occupational Therapy Department, Queen Elizabeth Hospital (2) Department of Orthopedics & Traumatology, Queen Elizabeth Hospital
Introduction :
Fragility hip fracture often leads to a decline in functional capacity in elderly patients. Functional outcome could be influence by a variety of factors. Understanding those factors may help occupational therapists intervene early to improve patient’s recovery and facilitate discharge and triage planning.
Objectives :
To identify factors related to functional prognosis after fragility hip fracture.
Methodology :
Patients aged 60 or above who suffered from fragility hip fracture and attended Fragility Fracture Day Rehabilitation Program (FFDR) after hospital discharge in between September 2022 to October 2023 were recruited in this retrospective study. All subjects underwent either conservative or operational intervention during the hospital stay. Occupational therapists, allied with doctors, nurses and physiotherapists, provide education on bone health, fall prevention and rehabilitation training in the FFDR. Demographics including age, gender, cognitive status measured by Abbreviated Mental Test (AMT), discharge destinations, length of stay in acute hospitals and post-fracture duration were collected and studied as independent factors. Functional status at premorbid and community phase was measured by Modified Barthel Index (MBI). Data were collected by occupational therapists at acute admission to hospital after the fracture occurrence and during subjects’ first attendance to FFDR after hospital discharge. Each subject's functional outcome was determined by the discrepancy in MBI score between the post-discharge status and premorbid status. Pearson’s correlation was used to analyze the correlation between the independent factors and the functional outcome. Factors that show association were further studied by regression analysis.
Result & Outcome :
141 subjects aged from 61 to 101 (mean age: 84) were recruited in the study. The mean reduction in MBI among all subjects was 20. Age (r= 0.336, p<0.001) and cognitive status in post-operative stage (r= -0.377, p<0.001) are correlated with functional outcome. Both of them are significant predictors of functional outcome (p<0.005). Age and cognitive status are found to be related to post-fracture functional prognosis. Patients with older age or poor cognitive status tend to have a poorer functional prognosis after fragility hip fracture. This could help early identification of those with greater odds of poor functional outcome. Measures for better care planning like carer education and home modification could be initiated at the early stage of rehabilitation.
