A basic mobility status of CAS <6 upon hospital discharge after hip fracture surgery was associated with a 1.5 times higher likelihood of 5-year mortality compared to achieving independence (CAS=6).
Cohort (n=444)
Does basic mobility status upon acute hospital discharge predict 1- and 5-year mortality in older patients after hip fracture surgery?
Basic mobility status upon acute hospital discharge is an independent risk factor for mortality up to 5 years after hip fracture surgery.
Hazard Ratio: 1.5
Absolute Event Rate: 78% vs 50%
Background and purpose - Mortality rates following hip fracture (HF) surgery are high. We evaluated the influence of the basic mobility status on acute hospital discharge to 1- and 5-year mortality rates after HF. Patients and methods - 444 patients with HF ≥60 years (mean age 81 years, 77% women) being pre-fracture ambulatory and admitted from their own homes, were consecutively included in an in-hospital enhanced recovery program and followed for 5 years. The Cumulated Ambulation Score (CAS, 0-6 points, 6 points equals independence) was used to evaluate the basic mobility status on hospital discharge. Results - 102 patients with a CAS <6 stayed in the acute ward a median of 22 (15-32) days post-surgery as compared with a median of 12 (8-16) days for those 342 patients who achieved a CAS =6. Overall 1-year mortality was 16%; in those with CAS <6 it was 30% and in those with CAS =6 it was 12%. Corresponding data for 5-year deaths were 78% and 50%. Multivariable Cox regression analysis demonstrated that the likelihood of not surviving the first 5 years after hip fracture was 1.5 times higher for those with a CAS <6 and for men; 2 times higher for those 80 years or older; increased by 50% per point higher ASA grade; and was reduced by 11% per point higher New Mobility Score, when adjusted for the cognitive and fracture type status. Interpretation - Further studies focused on interventions that improve the basic mobility status of patients with HF should be instigated within the early time period following surgery.
Kristensen et al. (Tue,) conducted a cohort in Hip fracture (n=444). Basic mobility status on acute hospital discharge (CAS <6) vs. CAS =6 (independence) was evaluated on 5-year mortality (HR 1.5). A basic mobility status of CAS <6 upon hospital discharge after hip fracture surgery was associated with a 1.5 times higher likelihood of 5-year mortality compared to achieving independence (CAS=6).