TY - JOUR T1 - The aftermath of hip fracture: discharge placement, functional status change, and mortality. JF - Am J Epidemiol Y1 - 2009 A1 - Suzanne E Bentler A1 - Li Liu A1 - Maksym Obrizan A1 - Elizabeth A Cook A1 - Kara B Wright A1 - John F Geweke A1 - Elizabeth A Chrischilles A1 - Claire E Pavlik A1 - Robert B Wallace A1 - Robert L. Ohsfeldt A1 - Michael P Jones A1 - Gary E Rosenthal A1 - Frederic D Wolinsky KW - Activities of Daily Living KW - Aged KW - Aged, 80 and over KW - depression KW - Female KW - Health Status KW - Health Status Indicators KW - Hip Fractures KW - Humans KW - Interviews as Topic KW - Iowa KW - Length of Stay KW - Logistic Models KW - Medicare KW - Patient Discharge KW - Prospective Studies KW - Psychometrics KW - Socioeconomic factors KW - Time Factors KW - Treatment Outcome KW - United States AB -

The authors prospectively explored the consequences of hip fracture with regard to discharge placement, functional status, and mortality using the Survey on Assets and Health Dynamics Among the Oldest Old (AHEAD). Data from baseline (1993) AHEAD interviews and biennial follow-up interviews were linked to Medicare claims data from 1993-2005. There were 495 postbaseline hip fractures among 5,511 respondents aged >or=69 years. Mean age at hip fracture was 85 years; 73% of fracture patients were white women, 45% had pertrochanteric fractures, and 55% underwent surgical pinning. Most patients (58%) were discharged to a nursing facility, with 14% being discharged to their homes. In-hospital, 6-month, and 1-year mortality were 2.7%, 19%, and 26%, respectively. Declines in functional-status-scale scores ranged from 29% on the fine motor skills scale to 56% on the mobility index. Mean scale score declines were 1.9 for activities of daily living, 1.7 for instrumental activities of daily living, and 2.2 for depressive symptoms; scores on mobility, large muscle, gross motor, and cognitive status scales worsened by 2.3, 1.6, 2.2, and 2.5 points, respectively. Hip fracture characteristics, socioeconomic status, and year of fracture were significantly associated with discharge placement. Sex, age, dementia, and frailty were significantly associated with mortality. This is one of the few studies to prospectively capture these declines in functional status after hip fracture.

PB - 170 VL - 170 IS - 10 U1 - http://www.ncbi.nlm.nih.gov/pubmed/19808632?dopt=Abstract U2 - PMC2781759 U4 - Functional Status/Mortality/Nursing Homes ER -