Development of a Prognostic Score to Predict Poor Ambulatory Ability Outcome at 3-Month in Hip Fracture Patients Who Completed Rehabilitation Programs after Surgery
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Abstract
BACKGROUND: Hip fracture is a leading cause of profound morbidity in individuals aged 65 and over. Worldwide, the number of people with hip fractures is expected to rise significantly due to the aging population. The mortality of hip fracture patients was significantly higher among those with age above 80, non ambulatory status before fracture, and upon hospital discharge. Ambulatory status is important for a patient’s quality of life.
OBJECTIVES: To create a predictive score for predicting ambulatory ability outcome at 3 months in hip fracture patients who had a rehabilitation program after surgery.
METHODS: The study was a retrospective cohort design conducted from October 2021 to September 2022 to predict prognosis in patients with hip fractures at Songkhla Hospital. A retrospective data search of patients' medical records. The study examined the clinical features that are linked with the ability to walk. Using multivariable logistic regression analysis, a clinical prediction factor was developed and transformed into scores using logistic coefficients, creating a predictive score.
RESULTS: The analysis included 132 patients classified into three groups: 32 with dependent ambulation, 72 with independent ambulation using gait aid, and 28 with independent ambulation. The predictive factors included in the score were age, pre-fracture status, type of operation, day from surgery to rehabilitation, and BI at discharge date. The constructed prediction score was divided into three levels: low risk (score<4.5), moderated risk (score 5-10.5), and high risk (score>11), which had a good performance in predicting ambulatory ability with an AuROC 0.84 (95%CI 0.77, 0.91), 0.81(95%CI 0.73, 0.90)
CONCLUSIONS: A clinical prediction score could predict ambulatory ability outcomes three months after surgery and a rehabilitation program. The scores should be tested using new patient groups (external validation) before the actual scores can be used.
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