In the Journals

Nursing home residents have poor survival, functional outcomes after hip fracture

After a hip fracture, nursing home residents were shown to have poor survival and functional outcomes, according to study results.

Researchers retrospectively collected data from Medicare claims and the Nursing Home Minimum Data Set for 60,111 Medicare beneficiaries residing in nursing homes and hospitalized with hip fractures between July 2005 and June 2009. Death from any cause at 180 days after fracture and a composite outcome of death or new total dependence in locomotion at the latest available assessment within 180 days were included as main outcome measures. Additional analyses included changes in function in seven activities of daily living before and after fracture.

Study results showed 36.2% of patients died by 180 days after fracture, and 53.5% of patients who were not totally dependent in locomotion at baseline died or developed new total dependence within 180 days. After fracture, function declined substantially across all activity of daily living domains assessed, according to the researchers.

Adjusted analyses revealed patients who were older than 90 years, received nonoperative fracture management or had advanced comorbidity had the greatest decreases in survival after fracture.

The researchers also found patients with very severe cognitive impairment, patients receiving nonoperative management and patients older than 90 years had a greater combined risk of death or new total dependence in locomotion within 180 days.

Disclosure: See the study for a full list of all authors’ relevant financial disclosures.

After a hip fracture, nursing home residents were shown to have poor survival and functional outcomes, according to study results.

Researchers retrospectively collected data from Medicare claims and the Nursing Home Minimum Data Set for 60,111 Medicare beneficiaries residing in nursing homes and hospitalized with hip fractures between July 2005 and June 2009. Death from any cause at 180 days after fracture and a composite outcome of death or new total dependence in locomotion at the latest available assessment within 180 days were included as main outcome measures. Additional analyses included changes in function in seven activities of daily living before and after fracture.

Study results showed 36.2% of patients died by 180 days after fracture, and 53.5% of patients who were not totally dependent in locomotion at baseline died or developed new total dependence within 180 days. After fracture, function declined substantially across all activity of daily living domains assessed, according to the researchers.

Adjusted analyses revealed patients who were older than 90 years, received nonoperative fracture management or had advanced comorbidity had the greatest decreases in survival after fracture.

The researchers also found patients with very severe cognitive impairment, patients receiving nonoperative management and patients older than 90 years had a greater combined risk of death or new total dependence in locomotion within 180 days.

Disclosure: See the study for a full list of all authors’ relevant financial disclosures.