Functional Status of Patients over 65 Years Old Intervened on for a Hip Fracture One Year after the Operation

Author:

Marrero-Morales Pablo A.1,González-Dávila Enrique2ORCID,Hernández-Gutiérrez María Fernanda1,Gallego-González Eva M.3,Jiménez-Hernández Martina4,Sanz-Álvarez Emilio J.5,Rodríguez-Novo Natalia6ORCID,Rodríguez-Novo Yurena M.6

Affiliation:

1. Department of Physical Medicine and Pharmacology, Faculty of Health Sciences, University of La Laguna, 38320 Santa Cruz de Tenerife, Spain

2. Department of Matemáticas, Estadística e Investigación Operativa, Instituto IMAULL, University of La Laguna, 38320 La Laguna, Spain

3. Traumatology Service, Complejo Hospitalario Universitario de Canarias, 38320 La Laguna, Spain

4. Medicine Section, University of La Laguna, 38320 La Laguna, Spain

5. Clinical Pharmacology Service, Complejo Hospitalario Universitario de Canarias, University of La Laguna, 38320 La Laguna, Spain

6. Nursing Section, Faculty of Health Sciences, University of La Laguna, 38200 Santa Cruz de Tenerife, Spain

Abstract

Objectives: Evaluation of the functional status one year after a hip fracture surgery and the influence of sarcopenia and other clinical factors at the time of admission. Method: Prospective observational study with 135 patients over 65 years of age. Functional status of basic (modified Katz) and instrumental activities (Lawton and Brody) and walking ability (Functional Ambulation Classification, FAC) was measured on admission, at discharge, and telephonically one year later. The risk or positive screening of sarcopenia (SARC-F) and cognitive status (Pfeiffer), as well as clinical variables, were evaluated. Results: 72% of patients are women; 36% have a risk of sarcopenia (Sarc-F ≥ 4), and 43% have moderate–severe cognitive impairment (Pfeiffer ≥ 5). Walking capacity at one year was closer to the values at admission more often in women than in men (0.2 ± 1.3 points vs. 0.9 ± 1.6; p = 0.001), as well as in patients without risk of sarcopenia versus sarcopenic patients (0.3 ± 1.2 points vs. 0.7 ± 1.7; p = 0.001), although their evolution did not show significant differences (p = 0.183). Instrumental activities after one year have not been recovered (1.7 ± 2.5 points; p = 0.032), and patients at risk of sarcopenia showed worse values (1.7 ± 1.9 points vs. 3.7 ± 2.7; p < 0.001) and worse evolution (p = 0.012). The evolution of basic activities varied according to the risk of sarcopenia (0.6 ± 1.4 points vs. 1.4 ± 2.1; p = 0.008). Conclusions: Functional status at one year is related to the functional status at admission, the positive screening of sarcopenia, sex, and cognitive impairment of the patient. Knowing at the time of admission an estimate of the functional status at one year will help to reinforce the individual treatment of patients with a worse prognosis.

Publisher

MDPI AG

Subject

Health Information Management,Health Informatics,Health Policy,Leadership and Management

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