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Improved Barthel Index Speed Is a Prognostic Indicator of Secondary Complications following Hip Hemiarthroplasty in
Kenta Kamo1, Akihisa Haraguchi1
1Department of Orthopedic Surgery, Yamaguchi Red Cross Hospital, Yamaguchi, Japan.
Purpose:
This study aimed to determine complication-free survival rates by assessing Barthel Index (BI) grades at discharge and to identify prognostic factors following hip hemiarthroplasty for femoral neck fractures.
Materials And Methods:
This retrospective study analyzed 404 patients. We collected data on BI scores following surgery and at discharge, BI improvement rate (BI speed), postoperative complications (dislocations, thrombosis, death, infection, and nerve disorder), and peri-hip fractures (contralateral and periprosthetic fractures).
Results:
Cluster analysis categorized patients into low (<35, n=92), moderate (40-80, n=199), and high (>85, n=113) BI groups. The moderate BI group showed an intermediate BI speed (1.97±1.31/day, P<0.001) and a peri-hip fracture incidence of 11.1% (P=0.015). Four-year complication-free survival rates were 47.5% in the low, 45.9% in the moderate, and 74.7% in the high BI groups (P<0.001). Multivariate analysis identified BI speed as a significant prognostic factor for complications (hazard ratio 0.746, 95% confidence interval 0.560-0.994, P<0.05).
Conclusion:
BI speed is a significant prognostic indicator for complications following hip hemiarthroplasty. Although it does not predict peri-hip fractures, the high fracture incidence in the moderate BI group suggests the need for targeted preventive interventions in this population.
