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Perceived Health Status and Capability after Hip Fracture: Secondary Outcomes from an Randomized Controlled Trial.

Maureen C Ashe1, Sanya Grover1, Stirling Bryan2,3

  • 1Department of Family Practice, The University of British Columbia (UBC), Vancouver, British Columbia, Canada.

Gerontology
|January 7, 2024
PubMed
Summary

Comprehensive geriatric care (CGC) did not improve health status or perceived capability in older adults after hip fracture compared to usual care. However, outcomes remained stable over 12 months, defying expected declines.

Keywords:
AgeingBoneFallsHip fracturesQuality of life

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Area of Science:

  • Geriatric Medicine
  • Orthopedics
  • Health Services Research

Background:

  • Hip fractures significantly impact older adults' lives and families.
  • Post-discharge care is crucial for recovery after hip fracture surgery.
  • Comprehensive Geriatric Care (CGC) aims to improve health outcomes for older adults.

Purpose of the Study:

  • To compare changes in health status and perceived capability 12 months after hip fracture surgery.
  • To evaluate the effectiveness of outpatient CGC versus usual care.
  • To assess health utility (EQ-5D-5L), quality of life (VAS), and capability (ICECAP-O).

Main Methods:

  • Pragmatic randomized controlled trial involving community-dwelling older adults (65+ years) after hip fracture repair.
  • Intervention: Usual care plus outpatient CGC clinic. Control: Usual care only.
  • Outcomes measured: EQ-5D-5L utility, VAS, and ICECAP-O at baseline, 6, and 12 months. Analysis: Area under the curve, regression, and constrained longitudinal data analysis.

Main Results:

  • No statistically significant differences were found between the CGC intervention and usual care groups for utility score, VAS, or capability.
  • Utility score difference: -0.028 (p=0.18); VAS difference: -0.03 (p=0.86); Capability difference: -0.021 (p=0.54).
  • Enrollment included 53 participants (mean age 80 years, 34 women).

Conclusions:

  • Outpatient CGC did not show significant benefits over usual care in improving health status or perceived capability 12 months post-hip fracture.
  • Despite the lack of difference, participant outcomes remained stable, contrary to expected declines.
  • Further research may explore optimal models of geriatric care for hip fracture patients.