Less than one-third of hip fracture patients return to their prefracture level of instrumental activities of daily living in a prospective cohort study of 480 patients

Abstract

Aim: A significant loss of instrumental activities of daily living (IADL) after a hip fracturehas been reported. The aim of the present study was to identify specific predictors for lowIADL after a hip fracture, in order to target better postoperative care for these patients.Methods: A prospective observational cohort study of 480 hip fracture patients was carriedout. IADL was measured at baseline, and after 3 and 12 months using the Groningen ActivityRestriction Scale. Multivariable logistic regression analysis was carried out using age, sex,American Society of Anesthesiologists classification, prefracture living with a partner, prefrac-ture living situation, prefracture use of walking aids, type of fracture, type of anesthesia, lengthof hospital stay, postoperative complications and prefracture IADL as potential predictors forlow IADL after a hip fracture. The correlation between IADL, mobility and living situation,both at admission, and 3 and 12 months postoperatively, were measured.Results: Three months after hip fracture treatment, 24% of patients returned to their base-line IADL level, at 12 months postoperative this was 29%. Factors associated with a largerloss in IADL after a hip fracture were older age, prefracture living with a partner, prefractureliving at home, prefracture use of walking aids and longer length of hospital stay. The correla-tion between IADL and living situation was 0.69, and between IADL and use of walking aidswas 0.80.Conclusions: A return to prefracture IADL level was low. Healthier patients have a steeperdecline in postoperative IADL.