INFLUENCE OF LEVEL OF INDEPENDENCE AND MOBILITY ON CONSEQUENT CARE AND MORTALITY IN PATIENTS AFTER TREATMENT OF PROXIMAL FEMORAL FRACTURES

Abstract

The ability of patients to return to their home environment after treatment of proximal femoral fractures is influenced to a significant extent by their level of independence and mobility prior to injury. In order to define independence and mobility precisely, we used the Harris Hip Score Questionnaire, the Barthel Index Questionnaire and the EQ-5D Questionnaire in patients with proximal femoral fractures. We followed 294 patients aged 50 or over, hospitalized from April 1, 2008, to April 28, 2009. The average time of follow-up was 7.3 months after injury. We compared the results for patients returning to their home environment and those staying in facilities providing consecutive care, in relation to the results of the questionnaires. As well as the results of the questionnaires, we looked at the influence of dementia and the presence of relatives at home on the ability of the patients to return to their home environment. We also looked at mortality in relationship to the same factors. 74.6 per cent of the 233 patients who were hospitalized from a home environment, eventually returned home. In all three questionnaires the scores were statistically significantly higher in the group of patients who finally returned home than in the group of patients who did not return home or died: in HHS, p = 0,003, in Barthel Score, p = 0,007 and in EuroQol, p < 0,001. Of those patients who returned home, more had been living with a relative prior to injury, than in the group of patients who did not return home. Dementia was observed significantly less in the group of patients who returned home (p< 0,001) Patients with a higher mobility score within the Harris Hip Score were found to have significantly higher survival rates (p = 0,004). The survival rates of patients with a higher Harris Hip Score, Barthel Score and EQ-5D did not show significant statistical differences.