Deconditioning of Long-Term Care Residents After Acute Hospitalization for a Hip Fracture in Ontario: A...

To describe hospital-associated deconditioning experienced by long-term care (LTC) residents after hospitalization for a hip fracture in Ontario, Canada.

Retrospective population-based cohort study using routinely collected data available through the Ontario Health Data Platform.

LTC residents who were hospitalized for a hip fracture between June 1, 2018, and November 1, 2021.

Descriptive analyses were completed on resident age, sex, and comorbidities. We presented residents' length of hospital stay, admission to the intensive care unit, alternative level of care designation, and 30-day readmission following discharge. Deconditioning markers included both physical and psychological measures of resident functional status and cognition pre- and post-hip fracture hospitalization.

We captured 4880 LTC residents who were hospitalized for a hip fracture between June 1, 2018, and November 1, 2021. Residents were on average 86.1 years old and predominately female (72%). Mean length of hospital stay was 6.97 days (SD 8.3), and 8% of residents died in hospital. Physical, cognitive, and psychological deconditioning were substantial postdischarge, especially in the ability to perform activities of daily living (10% dependent/totally dependent prehospitalization to 69% posthospitalization), balance while standing (20% severely impaired prehospitalization to 80% posthospitalization), health instability (6% with moderate to very high instability prehospitalization to 38% posthospitalization), and cognitive performance (1% with very severe impairment prehospitalization to 8% posthospitalization).

Markers of deconditioning demonstrate drastic declines in a variety of physical and psychological measures following hospitalization for a hip fracture among LTC residents.