Patient, surgical and hospital factors predicting actual first‐day mobilisation after hip fracture surgery: An observational cohort study

Abstract

AbstractObjectivesTo examine patient, surgical and hospital factors associated with Day‐1 postoperative mobility after hip fracture surgery in older adults.MethodsA cohort study using Australia and New Zealand Hip Fracture Registry was conducted. Participants were aged older than 50 years and underwent hip fracture surgery between 1 January 2020 and 31 December 2020 inclusive. The outcome was standing and step transferring out of bed onto a chair and/or walking Day‐1 after hip fracture surgery.ResultsMean age was 82 years and 68% were women. Of 12,318 patients with hip fracture, 5981 (49%) actually mobilised Day‐1. Odds of actual first‐day mobilisation were lower for individuals usually walking with either stick or crutch (OR = 0.71, 95% CI 0.62–0.82) or two aids or frame (OR = 0.57, 95% CI 0.52–0.64) or wheelchair/bed bound (OR = 0.24, 95% CI 0.17–0.33); who had impaired cognition preadmission (OR = 0.57, 95% CI 0.51–0.64); from aged care facilities (OR = 0.59, 95% CI 0.52–0.67); had an American Society of Anaesthesiologists grade 2 (OR = 0.63, 95% CI 0.41–0.97), 3 (OR = 0.31, 95% CI 0.20–0.47) or 4 or 5 (OR = 0.21, 95% CI 0.14–0.32); surgery delay >48 h (OR = 0.81, 95% CI 0.71–0.91); and restricted/non‐weight‐bearing status immediately postoperatively (OR = 0.53, 95% CI 0.42–0.67).ConclusionsBoth non‐modifiable and modifiable patient and surgical factors influence first‐day mobilisation after hip fracture surgery. Reducing time to surgery might assist future quality improvement efforts to increase Day‐1 postoperative mobility.