osteoporosis-2019-accepted-abstracts

Page 31

Volume 3

Pulsus Journal of Surgical Research

Osteoporosis 2019

March 13-14, 2019

Osteoporosis, Arthritis and Musculoskeletal Disorders

March 13-14, 2019, London, UK

International Conference on

Pulsus J Surg Res, Volume 3

Predictors of in-hospital ambulatory status following low energy hip fracture surgery

Jordan C Villa

Howard University Hospital, USA

Background:

25-75% of independent patients do not walk independently after Hip Fracture (HF), and many patients experience

functional loss. Early rehabilitation of functional status is associated with better long-term outcomes, however predictors of early

ambulation after HF have not been well described.

Purposes:

To assess the impact of perioperative and patient specific variables on in-hospital ambulatory status following low energy

HF surgery.

Patients and Methods:

This is a retrospective analysis of 463 geriatric patients that required HF surgery at a metropolitan Level 1

Trauma Centre. The outcomes were time to transfer (out of bed to chair) and time to walk.

Results:

392 (84.7 %) patients were able to transfer after surgery with a median time of 43.8 hours (quartile range 24.7- 53.69 hours)

while 244 (52.7%) patients were able to walk with a median time of 50.86 hours (quartile range 40.72-74.56 hours). Pre-injury

ambulators with aids (HR, 0.70, CI, 0.50-0.99), age >80 years (HR, 0.66, CI, 0.52-0.84), peptic ulcer disease (HR=0.57,CI, 0.57-0.82),

depression (HR, 0.66, CI, 0.49-0.89), time to surgery >24 hours (HR= 0.77, CI, 0.61-0.98) and surgery on Friday (HR= 0.73,

CI, 0.56-0.95) were associated with delayed time to transfer. Delayed time to walk was observed in patients over 80 years old (HR=

0.74, CI, 0.56-0.98), females (HR=0.67, CI, 0.48-0.94), peptic ulcer disease (HR=0.23, CI, 0.84-0.66) and depression (HR= 0.51, CI,

0.33-0.77).

Conclusions:

Operative predictors of delayed time to transfer were surgery on Friday, and time to surgery >24 hours after admission.

Depression is associated with delayed time to transfer and time to walk. This data suggests that is important to perform surgeries

within 24 hours of admission, identify deficiencies in care during the weekends, and create rehabilitation programs specific for

patient with depression. Improving functional rehabilitation after surgery may facilitate faster patient discharge, decrease inpatient

care costs, and better long-term functional outcomes.