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KMID : 1120320150010000029
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Osteoporosis and Sarcopenia
2015 Volume.1 No. 0 p.29 ~ p.29
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Rehabilitation Outcomes of Hip Fracture Patients in a Rehabilitation Hospital
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Yu Teresa
Myint Jennifer
Chan Dora
Tsang Annette
Pak Howard
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Abstract
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Introduction: Hip fracture is prevalent and treatment is costly. There were about 5490 hip fracture episodes in the Hong Kong in 2013. Because of the aging population, the number of hip fracture is expected to increase. Hip fracture is a major cause of morbidity and mortality to patients and its impact on society is substantial. One-year mortality rates have ranged from 12 to 37 percent and about one-half of patients are unable to regain their ability to live independently. Secondary prevention of osteoporosis is important in this population.
Objectives: To study the rehabilitation outcomes of hip fracture patients in a rehabilitation hospital and the rate of secondary prevention of osteoporosis among these patients.
Method: A retrospective cohort of hip fracture patients admitted to Kowloon Hospital (KH) from the period 1 April 2014 to 31 March 2015 was studied. Demographic and outcomes data were collected. Also, the proportion of patient discharged with calcium and vitamin D supplement or osteoporosis drugs were analyzed.
Results: A total of 351 hip fracture patients were admitted to KH from 1 April 2014 to 31 March 2015. The mean age was 82 years old (range 45?100) and 54% were female. Most patients (95%) lived at home prior to the fracture and among them 20.1% were discharged to nursing home. The mean admission total functional independence measure (FIM) score was 68 (range 18?110) and the discharge FIM score was 79 (range 14?117) with a FIM score gain of 11 points. The mean FIM motor subscore increased from 45 to 58 upon discharge with a gain of 13 points. The mean length of stay (LOS) in the rehabilitation ward was 30 days. 307 patients (87.5%) were prescribed with calcium and vitamin D supplement upon discharge and 88 patients (25.1%) received osteoporosis drugs (alendronate 76 patients, zoledronic acid 6 patients and denosumab 6 patients). The main reasons of not giving bisphosphonates included impaired renal function, impaired cognitive function, gastrointestinal problems, dental problems and patient's refusal.
Conclusions: Hip fracture patients being rehabilitated in a rehabilitation hospital were mostly elderly patient with mean age of 82 years old with a long average LOS of 30 days in the rehabilitation hospital and high proportion need to be discharged to nursing home. There was improvement in functional level after rehabilitation as reflected by total FIM score gain of 11 points. Great majority of patients (87.5%) were given calcium and vitamin D supplement upon discharge and 25.1% of patient received osteoporosis drugs. Rehabilitation of hip fracture in rehabilitation hospital is effective with improvement in functional level and a high rate of secondary prevention of osteoporosis.
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