Mental impairment of elderly hospitalized hip fracture patients

Mental impairment recorded at admission, following surgery and at discharge was assessed by studying the hospital records of 98 community residing persons, 60 years and older (mean age 76.2), hospitalized for a hip fracture and discharged alive. Of the total sample, the proportion mentally impaired following surgery was 33%. In a subsample of 74 patients for whom data were known at admission and after surgery, 15% were identified as persistently mentally impaired at admission and post-surgery, 26% were impaired only post-surgically and 59% had no recorded impairment either at admission or after surgery. Length of hospitalization (LOS) differed significantly among these three impairment groups, with persistently impaired having significantly longer stays (mean number of days = 53) than the never impaired (mean number of days = 24) and the newly impaired (mean number of days = 38) falling in between (p less than 0.005). Mental impairment continued to exhibit a significant and independent relationship with length of stay even when age and total diagnoses were held constant. The substantial prevalence of mental impairment during hospitalization, coupled with the increased length of stay in patients exhibiting impairment persisting from time of admission or newly evident after surgery, underscore the importance of mental status for recovery. Findings suggest that assessing the progression of mental impairment over the course of a hospital stay yields more accurate information about the relationship of mental status to recovery indicators and that accurate assessment of impairment at admission identifies a patient group at high risk for increased lengths of stay.(ABSTRACT TRUNCATED AT 250 WORDS)