Deconditioning of Long-Term Care Residents After Acute Hospitalization for a Hip Fracture in Ontario: A Retrospective, Population-Based Cohort Study

OBJECTIVE: To describe hospital-associated deconditioning experienced by long-term care (LTC) residents after hospitalization for a hip fracture in Ontario, Canada. DESIGN: Retrospective population-based cohort study using routinely collected data available through the Ontario Health Data Platform. SETTING AND PARTICIPANTS: LTC residents who were hospitalized for a hip fracture between June 1, 2018, and November 1, 2021. METHODS: Descriptive analyses were completed on resident age, sex, and comorbidities. We presented residents' length of hospital stay, admission to the intensive care unit, alternative level of care designation, and 30-day readmission following discharge. Deconditioning markers included both physical and psychological measures of resident functional status and cognition pre- and post-hip fracture hospitalization. RESULTS: We captured 4880 LTC residents who were hospitalized for a hip fracture between June 1, 2018, and November 1, 2021. Residents were on average 86.1 years old and predominately female (72%). Mean length of hospital stay was 6.97 days (SD 8.3), and 8% of residents died in hospital. Physical, cognitive, and psychological deconditioning were substantial postdischarge, especially in the ability to perform activities of daily living (10% dependent/totally dependent prehospitalization to 69% posthospitalization), balance while standing (20% severely impaired prehospitalization to 80% posthospitalization), health instability (6% with moderate to very high instability prehospitalization to 38% posthospitalization), and cognitive performance (1% with very severe impairment prehospitalization to 8% posthospitalization). CONCLUSIONS AND IMPLICATIONS: Markers of deconditioning demonstrate drastic declines in a variety of physical and psychological measures following hospitalization for a hip fracture among LTC residents.