What question did this study set out to answer?

To evaluate the impact of early surgical intervention and rapid postoperative rehabilitation on functional outcomes and pain relief in patients hospitalized with hip fractures.

December 29, 2023Folia MedicaOpen Access

Early hip fracture surgery and rehabilitation. How to improve functional quality outcomes. A retrospective study

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Hip fracture (n=140). Intervention: Early surgery (within 48 hours) vs. Late surgery (>48 hours). Primary outcome: Improvement of the Barthel Index at discharge (p=0.049).

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Key result

Early surgery within 48 hours significantly improved Barthel Index scores at discharge (p=0.049) and increased the proportion of patients restarting walking (30% vs 20%) compared to late surgery.

Why the study?

Hip fractures cause major disability, high morbidity, and mortality, but the effects of an early surgery and rehabilitation approach on functional outcomes required analysis.

Does early hip fracture surgery (within 48 hours) improve functional outcomes at discharge in older adults compared to delayed surgery?

Key Points

To evaluate the impact of early surgical intervention and rapid postoperative rehabilitation on functional outcomes and pain relief in patients hospitalized with hip fractures.
Retrospective analysis of N=140 adult patients (mean age 79.35±11.71 years, range 66–94) admitted with hip fractures to an orthopedic unit in Messina.
Interventions included hip replacement (63.14%) or internal fixation (37.86%), with structured physical therapy initiated within 48 hours post-surgery.
Outcomes were tracked post-surgery and prior to discharge using the Visual Analogue Scale for pain and the Barthel Index for functional capacity.
Surgery occurred within 48 hours in 68.42% of patients, with the overall cohort demonstrating improvements in both Barthel Index scores and pain levels between admission and discharge.
Higher comorbidity burden was associated with worse functional recovery, delayed timing of verticalization and unassisted walking, and inferior pain management.

Study Design

Type

Cohort (n=140)

Multicenter

Structured PICO

Does early hip fracture surgery (within 48 hours) improve functional outcomes at discharge in older adults compared to delayed surgery?

Population

140 older adults (mean age 79.4 years) with hip fractures who underwent surgery and inpatient rehabilitation, evaluated for functional outcomes at discharge.

Exposure

Early hip fracture surgery (within 48 hours of admission) followed by a rehabilitation protocol started within 48 hours after surgery (twice a day for 45 minutes).

Comparator

Late hip fracture surgery (>48 hours after admission) followed by the same rehabilitation protocol.

Outcome

Improvement of the Barthel Index at discharge with respect to admission.patient reported

Main Result

p-value: p=0.049

Early hip fracture surgery within 48 hours combined with early rehabilitation significantly improves functional recovery and walking ability by hospital discharge.

Limitations

Retrospective design lacking long-term follow-up data on revision surgeries and mortality rate
Conducted during the COVID-19 pandemic era, which limited admissions and follow-up in rehabilitation centers
Patient dropout, especially among the oldest patients, due to fear of contracting COVID-19
Time of the study (pandemic era) limited admissions and follow-up in rehabilitation centers
Patient dropout due to fear of getting COVID

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

May support better discharge function after early hip fracture surgery; leaves open confirmation in randomized trials.

Cite This Study

Alito et al. (2023) conducted a cohort in Hip fracture (n=140). Early surgery (within 48 hours) vs. Late surgery (>48 hours) was evaluated on Improvement of the Barthel Index at discharge (p=0.049). Early surgery within 48 hours significantly improved Barthel Index scores at discharge (p=0.049) and increased the proportion of patients restarting walking (30% vs 20%) compared to late surgery.

synapsesocial.com/papers/6a96e87b2d8f86faeeb2fc34 https://doi.org/10.3897/folmed.65.e99513

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Early hip fracture surgery and rehabilitation. How to improve functional quality outcomes. A retrospective study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Early hip fracture surgery and rehabilitation. How to improve functional quality outcomes. A retrospective study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider