Postsurgery paths and outcomes for hip fracture patients (POST-OP HIP PATHS): a population-based retrospective cohort study protocol

Factors Influencing Initial Rehabilitation Type after Hip Fracture Surgery: A Retrospective Cohort Study

OBJECTIVE

To describe and compare the factors that impact initial rehabilitation type after hip fracture surgery.

DESIGN

Retrospective population-based cohort study.

SETTING AND PARTICIPANTS

People aged between 50 and 105 with a hip fracture who had a surgical repair in Ontario, Canada, between January 1, 2015, and December 31, 2021.

METHODS

Descriptive statistics and a multinomial logistic regression model were used to identify factors associated with initial rehabilitation type.

RESULTS

In this study, 63,401 individuals were included with a mean age of 80 years [standard deviation (SD) 10.9], mostly female (67.3%), with 86.3% living in urban areas at the time of hospitalization and most (72.6%) admitted from the community without home care. A total of 24.5% of individuals did not receive any form of rehabilitation. Rurality of residence decreased the odds of having an initial rehabilitation type in complex continuing care [odds ratio (OR), 0.23; 95% CI, 0.21-0.26], in inpatient rehabilitation (OR, 0.26; 95% CI, 0.24-0.28), or in community rehabilitation (OR, 0.54; 95% CI, 0.50-0.58) compared with no rehabilitation. Dementia decreased the odds of having an initial rehabilitation type in complex continuing care (OR, 0.75; 95% CI, 0.69-0.81), in inpatient rehabilitation (OR, 0.44; 95% CI, 0.41-0.47), or in community rehabilitation (OR, 0.88; 95% CI, 0.82-0.95) compared with receiving no rehabilitation. Previous history of fragility fracture decreased the odds of having an initial rehabilitation type in either complex continuing care (OR, 0.30; 95% CI, 0.27-0.34), in inpatient rehabilitation (OR, 0.27; 95% CI, 0.24-0.29), or in community rehabilitation (OR, 0.33; 95% CI, 0.30-0.37) compared with no rehabilitation.

CONCLUSIONS AND IMPLICATIONS

Rurality of residence, dementia, and previous history of fragility fractures reduced the odds of receiving specialized inpatient rehabilitation and increased the odds of receiving no rehabilitation. Future research should focus on achieving more equitable care for individuals living in rural settings, with dementia, or with previous fragility fractures to enhance the quality of care and achieve best outcomes for the overall hip fracture population.

Related factors of postoperative half-year care utilization for health status and recovery in older adults with hip fracture: A retrospective study of Osaka National Health Insurance Data

AIM

The aim of this study was to investigate the relationship between preoperative patient factors and postoperative half-year health care utilization reflecting recovery, common complications, comorbidities, and significant health concerns, identifying strong risk and protective factors.

METHODS

This retrospective cohort study utilized linear, quantile, and ordinal regressions to analyze Osaka National Health Insurance data from 26 606 elderly patients who underwent hip fracture surgery between 2012 and 2018.

RESULTS

The key factors associated with multiple postoperative care utilizations (P < 0.001) included: 1 Compared with men, women were strongly negatively correlated with postoperative length of stay (LOS) at q90, diabetes prescriptions or drip injections, while showing strong positive associations with postoperative antihypertensive, antiosteoporosis, and antidementia prescriptions. 2 Age has a strong negative correlation with antiosteoporosis or diabetes prescriptions but strongly positive associations with indwelling urinary catheters or drip injections. 3 The preoperative 1-year LOS correlated positively with the postoperative LOS or indwelling urinary catheters, and the strongest associations were observed at q25 with the postoperative LOS. It was significantly and negatively associated with antihypertensive or antidementia prescriptions. 4 Many preoperative care utilizations were positive factors, and some were strong factors at q25 of the LOS.

CONCLUSIONS

Nuanced relationships between the female sex; preoperative LOS; antidementia, antiosteoporosis, antihypertensive and constipation prescriptions; indwelling catheters, and postoperative LOS were elucidated. These are key risks during shorter postoperative LOS, while male subgroups are at a higher risk during longer LOS duration. Patients with extended preoperative diabetes prescriptions or drip injections are at high risk of multiple postoperative care. Geriatr Gerontol Int 2025; 25: 190-205.

Early hip fracture surgery and rehabilitation. How to improve functional quality outcomes. A retrospective study

INTRODUCTION

Hip fractures are one of the major disability causes associated with a high morbidity and mortality rate. Early surgery and stable fixation could be associated with better pain control, possibly lower mortality rates, and early recovery of autonomy.