Abstract
Objectives
To examine the associations of 3 measures of prefracture health status (physical function,
mental function, and comorbidity count) with trajectories of physical and mental function
at 1.5, 3, 6, and 12 months after hip fracture surgery.
Design
Single-center observational study.
Setting
Singapore General Hospital (an acute hospital).
Participants
Patients aged ≥60 years who underwent first hip fracture surgery between June 2011
and July 2016 (N = 928).
Intervention
None.
Measurements
We used data collected prospectively from the hospital's hip fracture registry. We
used the Short Form–36 (SF-36) Physical Component Summary (PCS) and Mental Component
Summary (MCS) as indicators of physical and mental function, respectively, collected
at admission and at 1.5, 3, 6, and 12 months after hip fracture surgery. Comorbidity
count at admission was the sum from a list of 10 common diseases associated with poorer
physical function.
Results
Prefracture physical function and prefracture mental function demonstrated time-varying
associations (interaction P < .001 and P = .001, respectively) with postfracture physical function; the associations were
small initially but increased in strength up to 6 months and stabilized thereafter.
In contrast, the strength of the association between comorbidity count and postfracture
physical function were time-invariant (−0.52, P = .027). The strength of the associations between all 3 measures of prefracture health
status and postfracture mental function were also constant over time (0.09, P = .004, for physical function; 0.38, P < .001, for mental function; −0.70, P = .034, for comorbidity count).
Conclusions/Implications
The time-varying associations between prefracture health status and postfracture physical
function suggest that even for patients with good prefracture health status, initial
recovery may be slow. Our findings can be useful to clinicians and therapists in their
prognostic evaluations and in management of patients’ expectation for recovery.
Keywords
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Article info
Publication history
Published online: July 23, 2018
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
