Association between additional non-weekday rehabilitation and discharge function after hip fracture, modified by age...

Hip fractures are a significant health concern, particularly among elderly individuals. Postoperative rehabilitation, including additional non-weekday rehabilitation, plays a crucial role in improving functional outcomes.

To explore the factors that modify the association between additional non-weekday rehabilitation and the activities of daily living (ADL) levels at discharge in people with hip fractures.

A retrospective study was conducted using administrative claims data to analyze people aged ≥ 60 years with hip fractures who underwent surgery. The primary outcome was the Barthel Index as ADL scores at hospital discharge. Multivariable non-linear regression models were used to assess the modification of the association between additional non-weekday rehabilitation and ADL scores by different characteristics such as age, body mass index, ADL scores at admission, dementia, and surgery the day before or not before the non-weekday.

A total of 77 947 people were included. People who received additional non-weekday rehabilitation had significantly better ADL scores at discharge than those who received weekday-only rehabilitation. The association between additional non-weekday rehabilitation and better ADL scores at hospital discharge was greater in older people (mean differences between the rehabilitation groups [95% CI] at ages 60 were 2.53 [0.50-4.56], and at ages 90 were 5.47 [4.89-6.05]), and in those with lower ADL scores at admission. Furthermore, people without dementia had significantly better ADL scores at discharge than those with dementia, and people who underwent additional non-weekday rehabilitation had better ADL scores at discharge than those who underwent weekday-only rehabilitation, regardless of dementia.

Tailoring rehabilitation strategies for individual characteristics, particularly age and baseline functional status, may optimize outcomes in people with hip fractures. Additional non-weekday rehabilitation may be particularly beneficial for older people and those with lower ADL scores at admission.