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What are the predictors of functional improvement (FIM scores) in patients with hip fracture at discharge from a rehabilitation ward?
What are the predictors of functional improvement (FIM scores) in patients with hip fracture at discharge from a rehabilitation ward?
Age and baseline functional status, rather than BMI, are the primary predictors of functional recovery in hip fracture patients undergoing rehabilitation.
Age and admission FIM predict discharge function after hip fracture rehab; hypothesis-generating for BMI neutrality, requiring prospective validation.
To determine possible predictors of FIM scores in patients with hip fracture at discharge a prospective cohort study of 117 patients with either DHS or hip arthroplasty admitted to a rehabilitation service was done. They were classified into four subgroups of underweight (BMI < 18.5), normal (18.5 < BMI < 24.9), overweight (25 < BMI < 29.9) and obese (30 < BMI < 35). Functional evaluations using FIM score as well as sitting, standing, walking days and length of stay for each patient were assessed by a highly skilled therapist at rehabilitation admission; discharge and a post discharge follow up. Recovery was significant in terms of motor subscale. No significant correlation was evident between hospitalization and discharge time with respect to cognitive subscale. The study showed only the age and FIM score at hospitalization to be the independent predictors of total FIM score at discharge. Elevated BMI has not adverse effect on FIM gains in patients with hip fractures. Simple surgery methods such as DHS revealed earlier recovery time than complicated procedures.
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Shakouri et al. (2009) studied this question.
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