Early Mobilization and Predictors of Delayed Disposition for Geriatric Hip Fractures.

Area of Science:

• Orthopaedic surgery
• Geriatric trauma
• Rehabilitation medicine

Background:

• Hip fractures are a significant cause of morbidity and mortality in elderly patients.
• Length of hospital stay (LOS) is a key indicator of healthcare efficiency and patient outcomes.
• Perioperative factors can influence LOS, impacting resource utilization and patient recovery.

Purpose of the Study:

• To evaluate the impact of perioperative variables, specifically physical therapy (PT) and walking distance, on length of stay (LOS) in hip fracture patients.
• To identify factors contributing to prolonged hospital stays and delayed discharge in this population.

Main Methods:

• Retrospective review of 301 hip fracture patients (age ≥ 65) treated at a level I trauma center between 2017 and 2020.
• Analysis of perioperative variables including time to surgery and frequency of postoperative PT sessions within the first 3 days.
• Correlation of these variables with total hospital LOS and postoperative LOS.

Main Results:

• Longer LOS was associated with delayed surgery (>24 hours), major complications, discharge to subacute rehabilitation, and limited walking distance or lack of PT.
• Weekend/holiday PT deficits were noted, with higher percentages of no PT sessions on Saturdays and Sundays.
• Delayed surgery, major complications, discharge to subacute rehab, and reduced ambulation/PT were significant predictors of increased LOS.

Conclusions:

• Minimizing complications and maximizing postoperative PT and early ambulation are essential for reducing LOS in hip fracture patients.
• Inadequate mobilization and delayed disposition are linked to perioperative factors, particularly if surgery occurs around weekends or holidays.