Instrumental Activities of Daily Living—A Good Tool to Prospectively Assess Disability after a Second Contralateral Hip Fracture?

• Published in: Geriatrics (Basel) Vol. 5; no. 4; p. 67
• Main Authors: Dubljanin Raspopovic, Emilija, Marković Denić, Ljiljana, Tomanović Vujadinović, Sanja, Kadija, Marko, Nedeljković, Una, Ilić, Nela, Milovanović, Darko
• Format: Journal Article
• Language: English
• Published: MDPI 29-09-2020; MDPI AG
• Subjects: dementia; disability; hip fractures; mortality; rehabilitation; secondary hip fracture
• ISSN: 2308-3417; 2308-3417
• DOI: 10.3390/geriatrics5040067

The aim of this study was to determine the outcome for patients who sustain a second hip fracture compared with those who sustain a first fracture, and to define the optimal measure to evaluate functional outcome after second hip fracture. Methods: 343 patients with acute hip fractures who presented during a 12 month period were included in the study. Patients with a first (318 patients, 78.10 +/− 7.53 years) and second (25 patients, 78.96 +/− 6.02) hip fracture were compared regarding all baseline variables. Regression analysis was also performed to assess the independent relationship between the presence of a second hip fracture and observed outcome variables at discharge (physical disability, complications, length of stay, and mortality) and one-year after surgery (physical disability and mortality). Results: Disability when performing instrumentalized activities of daily living (IADL) at one-year follow-up is independently related to the presence of a second hip fracture. There were no other statistically significant relationships between the presence of a second hip fracture and other observed outcome variables. Conclusions: Patients with a second hip fracture showed worse functional outcome at one-year follow-up when measured with the IADL scale. No increased short-nor long-term mortality rates were found in patients with a secondary hip fracture. IADL is a good tool to assess disability after a second hip fracture and could be thus a more reliable outcome measure when investigating differences in functional recovery in patients with a second hip fracture compared to conventionally used ADL scales.