Early Ambulation After Hip Fracture Surgery Is Associated With Decreased 30-Day Mortality

Area of Science:

• Geriatric Medicine
• Orthopedic Surgery
• Public Health

Background:

• Hip fractures are common in elderly patients, associated with high rates of morbidity and mortality.
• Delayed postoperative ambulation is a known risk factor for increased mortality after hip fracture surgery.
• The precise impact of early ambulation on mortality requires further quantification, especially considering patient comorbidities.

Purpose of the Study:

• To evaluate the association between early postoperative ambulation and mortality after hip fracture surgery.
• To quantify the magnitude of mortality risk related to delayed ambulation.
• To account for the influence of preexisting comorbidity burden on this relationship.

Main Methods:

• Retrospective review of patients aged 65 years and older undergoing hip fracture fixation.
• Recording of ambulation status during the first 3 postoperative days.
• Analysis of 30-day and 1-year mortality using multivariable logistic regression, controlling for age and the Modified 5-Factor Frailty Index.

Main Results:

• Patients who did not ambulate within 3 days had significantly higher 30-day (OR 4.42) and 1-year (OR 2.26) mortality.
• After adjusting for age and frailty, early ambulation remained strongly associated with reduced 30-day mortality (OR 3.87).
• Increasing age and higher Modified 5-Factor Frailty Index scores correlated with increased 1-year mortality.

Conclusions:

• Early ambulation after hip fracture surgery is independently associated with a significant reduction in early postoperative mortality.
• Ambulation is a critical factor for optimizing outcomes and reducing mortality in hip fracture patients.
• These findings reinforce the importance of prioritizing early mobilization in the postoperative care of hip fracture patients.