Patient, surgical and hospital factors predicting actual first‐day mobilisation after hip fracture surgery: An observational cohort study

With regard to an article recently published in your journal titled ‘Patient, surgical and hospital factors predicting actual first-day mobilisation after hip fracture surgery: An observational cohort study’ by Victoria Woodcroft-Brown et al.,1 the authors provided the readers with a commendably detailed study, and their work is highly admired. This research imparts considerable information about the topic and makes a significant impact on the field. However, there are some aspects that we think need greater emphasis, specifically relating to additions from several other articles that might enhance the research's justifiability and validity. The study's authors have addressed patients' preoperative clinical conditions, but they appear not to have investigated the relationship between the outcomes and common comorbidities like diabetes and hypertension, which can impact early postoperative mobilisation. This is our primary concern. In comparison with individuals without diabetes, patients with type 2 diabetes have a lower mobilisation capacity, similar to individuals presenting with hypertension, cerebrovascular insults and osteoporosis—a condition common to older adults and postmenopausal women.2 Furthermore, the article did not provide information regarding therapies that might enhance patients' functional results. A better postoperative lifestyle and early mobilisation can be offered to the patient using various factors such as environmental modifications, occupational therapy, physical therapy (to manage emotional and social needs), nutrition supports (pre- and postoperative), fall prevention and self-care training.3 These factors can encourage the patient to engage in early mobilisation. The fact that high opioid dosage is necessary for early mobilisation to overcome the negative effects of severe pain from weight-bearing physical activity is our third area of concern, one which we feel the authors should have addressed. The potential health risks associated with opioid side effects should also be investigated.4 Finally, the authors could have elaborated on some common factors among patients, such as the intensity of pain, fatigue, proper sleep and premorbid mobility.5 These factors also cause delays in patient mobility. Regardless of the points raised above, the article has a significant overall yield. However, as researchers, we think there is always room for improvement, and if any changes are required, they should be made as doing so will increase our understanding of the study as a whole. The authors have nothing to report. No conflicts of interest declared.