Effects of geriatric interdisciplinary home rehabilitation on complications and readmissions after hip fracture: a randomized controlled trial

Author:

Berggren Monica1ORCID,Karlsson Åsa1,Lindelöf Nina12,Englund Undis1,Olofsson Birgitta34,Nordström Peter1,Gustafson Yngve1,Stenvall Michael1

Affiliation:

1. Geriatric Medicine, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden

2. Physiotherapy, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden

3. Orthopaedics, Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden

4. Department of Nursing, Umeå University, Umeå, Sweden

Abstract

Objective: This pre-planned secondary analysis of geriatric interdisciplinary home rehabilitation, which was initially found to shorten the postoperative length of stay in hospital for older individuals following hip fracture, investigated whether such rehabilitation reduced the numbers of complications, readmissions, and total days spent in hospital after discharge during a 12-month follow-up period compared with conventional geriatric care and rehabilitation. Design: Randomized controlled trial. Setting: Geriatric department, participants’ residential care facilities, and ordinary housing. Subjects: Individuals aged ⩾70 years with acute hip fracture ( n = 205) were included. Intervention: Geriatric interdisciplinary home rehabilitation was individually designed and aimed at early discharge with the intention to prevent, detect, and treat complications after discharge. Main measures: Complications, readmissions, and days spent in hospital were registered from patients’ digital records and interviews conducted during hospitalization and at 3- and 12-month follow-up visits. Results: No significant difference in outcomes was observed. Between discharge and the 12-month follow-up, among participants in the geriatric interdisciplinary home rehabilitation group ( n = 106) and control group ( n = 93), 57 (53.8%) and 44 (47.3%) had complications ( P = 0.443), 46 (43.4%) and 38 (40.9%) fell ( P = 0.828), and 38 (35.8%) and 27 (29.0%) were readmitted to hospital ( P = 0.383); the median total days spent in hospital were 11.5 and 11.0 ( P = 0.353), respectively. Conclusion: Geriatric interdisciplinary home rehabilitation for older individuals following hip fracture resulted in similar proportions of complications, readmissions, and total days spent in hospital after discharge compared with conventional geriatric care and rehabilitation.

Funder

the Strategic Research Program in Care Sciences, Sweden

the University of Umeå and County Council of Västerbotten

the Swedish Dementia Association

the Foundation of the Medical Faculty

the Swedish Research Council 2014

Publisher

SAGE Publications

Subject

Rehabilitation,Physical Therapy, Sports Therapy and Rehabilitation

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