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A short comprehensive assessment to predict outcome of elderly patients after hip fracture
Sophie Pautex1, Marie-Claire Jacques, Aditya Sant
1Geriatric Evaluation Unit, University Hospitals of Geneva, Switzerland. sophie.pautex@hcuge.ch
Background And Aims:
Hip fractures result in significant functional impairment and a high rate of institutionalization. The aim of our study was to evaluate in patients with a recent hip fracture the contribution of a short (15-min) comprehensive assessment to predict the length of stay and the risk of discharge to a nursing home.
Methods:
Prospective clinical study conducted in a rehabilitation ward of the Geriatric Hospital. Functional assessment included basic activities of daily living (BADL), cognitive status (MMSE) and a 4-item geriatric depression scale (Mini-GDS). Information on demographic data, living situation, diagnosis and illness burden was also collected.
Results:
The mean age of the 86 patients (67W/19M) was 84.2 +/- 6.8 years. In a multiple regression analysis, the length of stay in a geriatric hospital was significantly associated with both marital status (living alone) (p = 0.035) and the intervention of a caregiver on a regular basis (p = 0.036), but not with Charlson's comorbidity score. In a logistic regression model, adjusted for age, gender, marital status, intervention of a caregiver on a regular basis, BADL, Mini-GDS and Charlson's comorbidity score, the only independent predictor of nursing home admission was a MMSE < 24, which increased by 10.7-fold (2.2-50.9) the risk of being admitted to a nursing home (p = 0.003).
Conclusions:
A short comprehensive assessment completed a few days after a hip fracture is useful in predicting length of stay and risk of nursing home admission.