Key result
Greater Katz Index functional dependence predicts ~166% higher long-term mortality after hip fracture surgery.
Why the study?
The potential usefulness of geriatric scores as predictors of survival and readmission rates after hip fracture surgery in older patients was not established.
Do geriatric scores predict long-term survival and readmission rates in older adults after hip fracture surgery?
Observational (n=207)
No
Do geriatric scores predict long-term survival and readmission rates in older adults after hip fracture surgery?
Geriatric scores such as the Barthel Index and Katz Index are significant predictors of long-term survival and readmission rates in older patients following hip fracture surgery.
Answers are grounded in this paper and cite their sources.
Katz dependence may inform post-hip fracture prognosis discussions; leaves open whether it improves risk stratification or guides interventions.
Background: The management of hip fractures is nowadays mainly performed in Orthogeriatric Units, one of whose fundamental tools is the application of geriatric scores. The purpose of this study is to establish the potential usefulness of Barthel Index, Katz Index, Lawton-Brody Index and Physical Red Cross Scale geriatric scores as predictors of survival rate and readmission rate in older patients after hip fracture surgery. Methods: We designed a prospective single-center observational study, including 207 older adults over age 65 who underwent hip fracture surgery in the first half of 2014 and followed up to September 2018. Cumulative survival and readmission rates were analyzed by Kaplan-Meier; group comparison, by Log-Rank and hazard ratio, by Cox regression. Results: We found statistical differences (p<0.001) for cumulative survival rate by every geriatric score analyzed (BI HR=0.98 [0.97,0.99]; KI HR=1.24 [1.13-1.37]; LBI HR= 1.25 [1.16, 1.36]; PCRS HR=1.67 [1.37,2.04]). Furthermore, we could determinate an inflection point for survival estimation by Barthel Index (BI 0-55/60-100*, p<0.001, HR=2.37 [1.59,3.53]), Katz Index (KI A-B*/C-G, p<0.001, HR=2.66 [1.80, 3.93], and Lawton-Brody Index (LBI 0-3/4-8*, p<0.001, HR=3.40 [2.09,5.25]). We reveal a correlation of the Charlson Index (p=0.002) and Katz Index (p=0.041) with number of readmissions for the study period. Conclusions: The geriatric scores analyzed are related to the cumulative survival rate after hip fracture surgery for more than 4 years, independently of other clinical and demographic factors. Katz Index in combination with Charlson Index could also be a potential predictor of the number of readmissions after surgery for hip fracture patients.
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Casa et al. (2019) conducted an observational in Hip fracture (n=207). Geriatric scores (Katz Index dependence) vs. Katz Index independence (Score A-B) was evaluated on Cumulative survival rate based on Katz Index inflection point (C-G vs A-B) (HR 2.66, 95% CI 1.80-3.93, p=<0.001). Greater functional dependence measured by the Katz Index (scores C-G versus A-B) significantly predicted worse long-term survival after hip fracture surgery (HR 2.66).
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