Functional Predictors for Home Discharge after Hip Fracture in Patients Living in Sloped Neighborhoods or Islands: An 8-Year Retrospective Cohort Study

Abstract

Functional predictors of home discharge after hip fractures have been widely reported; however, no study has considered the geographical features surrounding patients’ homes. This study aimed to identify home discharge predictors and determine the cutoff points required for home discharge of patients living in sloped neighborhoods or islands. A total of 437 postoperative hip fracture patients were included and classified into the flat, slope, and island groups according to their residential area before the fracture. Multivariate logistic regression analysis was used to identify significant home discharge predictors, and receiver-operating characteristic analysis to calculate cutoff values. In all the groups, the functional independence measure-motor score was a significant home discharge predictor, with cutoff values of 69 for the flat group and 65 points for the slope and island group. In the slope group, the 6-minute walking distance (odds ratio, 1.02; 95% confidence interval, 1.01–1.04) and revised Hasegawa dementia scale score (odds ratio, 1.06; 95% confidence interval, 1.01–1.12) were also identified as predictors, with cutoff values of 150 m and 18 points, respectively. The outcomes required for home discharge after hip fracture differ depending on the neighborhood terrain, especially for patients living in areas with many slopes and stairs.