Association between additional weekend rehabilitation and functional outcomes in patients with hip fractures: Does age affect the effectiveness of weekend rehabilitation ?

Abstract

Abstract Purpose Rehabilitation after hip fracture surgery is crucial for improving physical function. Additional rehabilitation over the weekend or after working hours is reportedly associated with improved physical function; however, this may not apply to an aging population, including patients aged > 90 years. This study aimed to investigate the association between additional weekend rehabilitation and functional outcomes in different age groups. Methods This study analysed a cohort of patients aged ≥ 60 years who had hip fractures and were operated on from 2013 to 2018. Data were extracted from a nationwide multicentre database. Functional outcomes at discharge were compared between patients who underwent rehabilitation on weekdays only and those who underwent rehabilitation on both weekdays and weekends. The patient groups were selected using propensity score matching analysis. Furthermore, a sub-analysis was conducted on patients in their 60s, 70s, 80s, and 90s. Results A total of 411,056 patients underwent surgery during the study period. After matching, each group comprised 129,583 patients. Patients who underwent weekend rehabilitation exhibited improved physical function in transferring, walking, and stair climbing at discharge, as compared with patients who did not (odds ratio [95% confidence interval]: 1.17 [1.15–1.19], 1.17 [1.15–1.2], and 1.06 [1.03–1.08], respectively). Except for stair climbing, the positive association between weekend rehabilitation and patient function was observed across all age groups. Conclusion Weekend rehabilitation was significantly associated with improved physical function. Given the limited healthcare resources, high-demand activities such as stair climbing may be reserved for younger age groups to optimise rehabilitation therapy.