PROSPECTIVE FOLLOW-UP OF THE LIVING SITUATION OF 339 HIP FRACTURE PATIENTS

Abstract

Introduction: Since January 2008 a large set of parameters of each hip fracture patient admitted to the RdGG hospital, were documented prospectively. This documentation was repeated by a written survey 3 months and 1 year after the fracture.

Our research goal was to determine the percentage of patients returning to their living situation prior to their fracture.

Methods: From 1-1-2008 to 1-3-2009, 339 hip fracture patients were treated, 244 female, 95 male. Average age was 78.1 (21–101). ASA distribution showed 240 ASA I/ II patients and 99 ASA III/IV patients. Conservative treatment was chosen in 7 patients, 213 were treated with an osteosynthesis and 117 with a (hemi)-arthroplasty. All patients received a survey regarding their living situation 3 and 12 months after their hip fracture.

Results: 327 patients could be analyzed as the pre fracture living situation of 12 patients was unknown; 71% lived independently, 21% in a care home and 9% in a nursing home. The follow-up (FU) of the living situation of the first two groups was analyzed.

Patients living independently: 45% was discharged directly to their own home, 24% to a nursing home and 3% to a care home. A special rehabilitation unit within our hospital, the “Herstel Unit”, received 28% of patients for further recovery. Patients could rehabilitate here for a maximum of 4 weeks before going home. After 3 months 84% of the patients had returned to their independent living situation, 11% lived in a nursing home and 5% in a care home. This analysis is done in 184 patients as 12 had died and 35 were lost to FU. After 12 months 38 (84%) of 45 still lived independently, 4 went to a nursing home, 3 to a care home, 21 died and 4 were lost to FU.

Care home patients: 47% was discharged directly to their care home, 15% to the “Herstel Unit” and 37% to a nursing home. At 3 months 69% of the patients had returned to their care home, 31% lived in a nursing home. Analysis is done in 45 patients as 15 had died and 8 were lost to FU. 12 months FU is accomplished in 27 patients of whom 19 died, none lost to FU; 88% lived in a care home, 12% in a nursing home.

Conclusions: More than 80% of the pre operative independently living patients have returned to their own independent living situation within 3 months. At 1 year FU this percentage is steady. 52% of this population stayed briefly on an alternative location for further recovery. The patients living in a care home have stayed longer on an alternative location, but more than 90% of them have returned to their pre fracture living situation at 12 months FU.

Our results challenge the prejudice that hip fracture patients live or end up living in a nursing home. These data can be used to calculate the amount of specific discharge locations needed in the near future.