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Short- and long-term prognostic factors associated with functional recovery in elderly patients with hip fracture: A systematic review

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Abstract

Summary

This systematic review aimed to identify short- and long-term associated factors to functional recovery of elderly hip fracture patients after discharge. We identified 43 studies reporting 74 associated factors to functional recovery; most of them were biological, sociodemographic, or inherent factors to patients' baseline characteristics, including their pre-facture functional capacity.

Purpose

This systematic review aimed to identify short- and long-term associated factors to functional recovery of elderly hip fracture patients after hospital discharge. We assessed the use of the hip fracture core-set and key-performance indicators for secondary fracture reduction.

Methods

A search was performed in seven electronic databases. Observational studies reporting predictors after usual care of elderly patients with hip fracture diagnoses receiving surgical or conservative treatment were included. Primary outcomes considered were part of the domains corresponding to functional capacity.

Results

Of 3873 references identified, and after the screening and selection process, 43 studies were included. Sixty-one functional measures were identified for ten functional outcomes, including BADLs, IADLs, ambulation, and mobility. Biological characteristics such as age, sex, comorbidities, cognitive status, nutritional state, and biochemical parameters are significantly associated. Determinants such as contact and size of social network and those related to institutional care quality are relevant for functional recovery at six and 12 months. Age, pre-fracture function, cognitive status, and complications continue to be associated five years after discharge. We found 74 associated factors to functional recovery of elderly hip fracture patients. Ten of the studies reported rehabilitation programs as suggested in KPI 9; none used the complete hip fracture core-set.

Conclusion

Most of the associated factors for functional recovery of elderly hip fracture were biological, sociodemographic, or inherent factors to patients' baseline characteristics, including their pre-facture functional capacity. For the core-set and KPI's, we found an insufficient use and report. This study reports 61 different instruments to measure functional capacity.

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Data availability

Search strategies and references of excluded studies are available on the Electronic Supplemental material.

Code availability

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Acknowledgements

We would like to thank “Consejo Nacional de Ciencia y Tecnología (CONACYT)”, Universidad Nacional Autónoma de México and the “Programa de Maestría y Doctorado en Ciencias Médicas, Odontológicas y de la Salud” for the support during the postgraduate studies of Ms. Berenice Araiza-Nava (CVU 923656) and Ms. Brenda M. Martínez-Hernández. We also would like to thank MSc. Griselda Adriana Cruz Priego for her support with the graphics for this research work.

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BA-N and LM-S developed the review question and the systematic review methodology, were part of the review process and wrote the manuscript; PC and MLP-P contributed in the methodology development and in the preparation of the manuscript; MKJ and MC contributed to the manuscript preparation and the clinical relevance interpretation of the results and discussion, BMM-H contributed as a reviewer and to the discussion as one of our physiotherapy experts; FG-J contributed with the clinical relevance interpretation the results and discussion as our rehabilitation medical expert.

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Correspondence to Lucia Méndez-Sánchez.

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MKJ has received honoraria and grant support from Amgen, UCB and Kyowa Kirin Hakin outside the development of this manuscript. MC works for International Osteoporosis Foundation. BA-N, LM-S, PC, MLP-P, BMM-H, and FG-J declare that they have no conflicts or competing interests.

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Araiza-Nava, B., Méndez-Sánchez, L., Clark, P. et al. Short- and long-term prognostic factors associated with functional recovery in elderly patients with hip fracture: A systematic review. Osteoporos Int 33, 1429–1444 (2022). https://doi.org/10.1007/s00198-022-06346-6

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