- Title
- The influence of weight-bearing status on post-operative mobility and outcomes in geriatric hip fracture
- Creator
- Tarrant, Seth Michael; Attia, John; Balogh, Zsolt Janos
- Relation
- European Journal of Trauma and Emergency Surgery Vol. 48, Issue 5, p. 4093-4103
- Publisher Link
- http://dx.doi.org/10.1007/s00068-022-01939-6
- Publisher
- Springer
- Resource Type
- journal article
- Date
- 2022
- Description
- Purpose: We hypothesized that unrestricted or full weight-bearing (FWB) in hip fracture would increase the opportunity to mobilize on post-operative day 1 (POD1mob) and be associated with better outcomes compared with restricted weight-bearing (RWB). Methods: Over 4 years, 1514 geriatric hip fracture patients aged 65 and above were prospectively recruited. Outcomes were compared between FWB and RWB patients. The primary outcome was 30-day mortality. Secondary outcomes were immobility-related adverse events, length of stay (LOS), and reoperation for failure. Causal effect modelling and multivariate regression with mediation analyses were performed to examine the relation between weight-bearing status (WBS), POD1mob, and known mortality predictors. Results: FWB was allowed in 1421 (96%) of 1479 surgically treated patients and RWB enforced in 58 (4%) patients. Mortality within 30 days occurred in 141 (9.9%) of FWB and 3 (5.2%) of RWB patients. In adjusted analysis, RWB did not influence 30-day mortality (OR 0.42, 95% CI 0.15–01.13, p = 0.293), with the WBS accounting for 91% of the total effect on mortality and 9% contributed from how WBS influenced the POD1mob. RWB was significantly related to increased DVT (OR 7.81, 95% CI: 1.81–33.71 p = 0.002) but no other secondary outcomes. Patients that did not have the opportunity to mobilize had increased 30-day mortality (OR 2.31, 95% CI 1.53–3.48 p < 0.001). Conclusion: Restricted weight-bearing was not associated with increased 30-day mortality. Only a small proportion of this effect was mediated by POD1mob. Whilst post-surgical WBS may be difficult to influence for cultural reasons, POD1mob is an easily modifiable target that is likely to have a greater effect on 30-day mortality. Level of evidence: Level III, observational study.
- Subject
- hip fracture; mobility; weight-bear; mortality; outcomes
- Identifier
- http://hdl.handle.net/1959.13/1478145
- Identifier
- uon:50119
- Identifier
- ISSN:1863-9933
- Rights
- This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
- Language
- eng
- Full Text
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