Baseline and 1-year follow-up differences between hip-fracture patients admitted from nursing homes and the community. A cohort study on 509 consecutive patients (FONDA Cohort) |
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| Institution: | 1. Servicio de Geriatría, Hospital Universitario La Paz, Madrid, España;2. Instituto de Investigación del Hospital Universitario La Paz, IdiPAZ, Madrid, España;3. Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, España;1. Servicio de Reumatología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España;2. Departamento de Ciencias Médicas y Quirúrgicas, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España;3. Departamento de Ciencias Clínicas, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España;4. Servicio de Oncología Radioterápica, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España;1. Orthopedic Department, Rabin Medical Center, Beilinson Hospital, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;2. Orthopedic Department, Wolfson Hospital, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;1. Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China;2. North AnHui Health Vocational College, Suzhou, Anhui 234000, China;1. Sección de Geriatría, Complejo Asistencial de Segovia, Segovia, España;2. Unidad de Geriatría, Complejo Asistencial de Ávila, Ávila, España;3. Unidad de Geriatría, Complejo Asistencial Universitario de León, León, España;4. Servicio de Traumatología, Complejo Asistencial de Ávila, Ávila, España;5. Unidad de Geriatría, Complejo Asistencial de Palencia, Palencia, España;6. Unidad de Geriatría, Hospital de Medina del Campo, Medina del Campo, España;7. Unidad de Geriatría, Complejo Asistencial de Burgos, Burgos, España;8. Unidad de Geriatría, Hospital Santos Reyes, Aranda de Duero, España;9. Unidad de Geriatría, Complejo Asistencial Universitario de Salamanca, Salamanca, España;10. Unidad de Geriatría, Hospital Clínico Universitario de Valladolid, Valladolid, España;11. Unidad de Geriatría, Hospital Universitario Río Hortega, Valladolid, España;12. Unidad de Geriatría, Hospital Santiago Apóstol, Miranda de Ebro, España;13. Unidad de Geriatría, Hospital El Bierzo, Ponferrada, España;14. Unidad de Geriatría, Complejo Asistencial de Zamora, Zamora, España;15. Área de Salud de Segovia, Segovia, España;p. Servicio de Geriatría, Hospital San Juan de Dios, León, España;q. Instituto de Investigación Hospital Universitario La Paz, Fundación Idi Paz, Ávila, España;1. Department of Geriatric Medicine and Palliative Care, Badalona Serveis Assistencials, Catalonia, Spain;2. Universitat Autònoma de Barcelona, Medicine Department, Catalonia, Spain;3. Catalonia Geriatrics and Gerontology Society, Catalonia, Spain;4. Unitat d’Informació i Coneixement, Servei Català de la Salut, Catalonia, Spain;5. Chronic Care Program, Ministry of Health, Generalitat de Catalunya, Catalonia, Spain;6. Parc Sanitari Pere Virgili, Barcelona, Spain;7. University Assistance Network of Manresa (ALTHAIA), Barcelona, Spain |
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| Abstract: | ObjectiveTo determine the clinical and functional differences at hospital admission and at 1 year after a hip fracture (HF) in nursing homes (NH) and community-dwelling (CD) patients.MethodsAll patients with HF admitted to the orthogeriatric unit at a university hospital between January 2013 and February 2014 were prospectively included. Clinical and functional variables, and mortality were recorded during the hospital admission. The patients were contacted by telephone at 1 year to determine their vital condition and functional status.ResultsA total of 509 patients were included, 116 (22.8%) of whom came from NH. Compared with the CD patients, the NH patients had higher surgical risk (ASA ≥3: 83.6% vs. 66.4%, P < .001), poorer theoretical vital prognosis (Nottingham Profile ≥5: 98.3% vs. 56.6%, P< .001), higher rate of previous functional status (median Barthel index: 55 IQR, 36-80] vs. 90 IQR, 75-100], P< .001), poorer mental status (Pfeiffer's SPMSQ >2: 74.1% vs. 40.2%, P< .001), and a higher rate of sarcopenia (24.3% vs. 15.2%, P< .05). There were no differences in in-hospital or at 1-year mortality. At 1 year, NH patients recovered their previous walking capacity at a lower rate (38.5% vs. 56.2%, P< .001).ConclusionsAmong the patients with HF treated in an orthogeriatric unit, NH patients had higher, surgical risk, functional and mental impairment, and a higher rate of sarcopenia than CD patients. At 1 year of follow-up, NH patients did not have higher mortality, but they recovered their previous capacity for walking less frequently. |
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| Keywords: | Hip fracture Nursing homes Community Functional recovery Mortality Fractura de cadera Residencia de ancianos Comunidad Recuperación funcional Mortalidad |
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