Advertisement

Rehabilitation after proximal femur fracture surgery in the oldest old

  • Devora Lieberman
    Affiliations
    Department of Geriatrics (Devora Lieberman) and Division of Internal Medicine (David Lieberman), Soroka University Medical Center of Klalit Health Services, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
    Search for articles by this author
  • David Lieberman
    Affiliations
    Department of Geriatrics (Devora Lieberman) and Division of Internal Medicine (David Lieberman), Soroka University Medical Center of Klalit Health Services, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
    Search for articles by this author

      Abstract

      Lieberman D, Lieberman D. Rehabilitation after proximal femur fracture surgery in the oldest old. Arch Phys Med Rehabil 2002;83:1360-3. Objective: To assess the course and results of rehabilitation after proximal femur fracture (PFF) in patients 85 years of age or older, compared with younger elderly patients, with an emphasis on functional status. Design: Prospective cohort study. Setting: A rehabilitation geriatric ward in a tertiary university hospital in southern Israel. Participants: The study group included 127 elderly patients 85 years of age or older who were hospitalized for rehabilitation following surgery for PFF. The comparison group was comprised of 297 patients aged 75 to 84 years who were hospitalized for the same indication in the same time period. Interventions: Not applicable. Main Outcome Measures: Functional studies by FIM™ instrument, mental status by the Folstein Mini-Mental State Examination, Geriatric Depression Screening (GDS) scale, length of rehabilitation, and complications and mortality during rehabilitation. Results: Compared with patients aged 75 to 84 years, the older study group was in a worse mental state (P=.00005), even though the groups did not differ in their GDS scores. There were no significant differences between the groups in rehabilitation length of stay, in the rate of most postoperative complications, or in death rates during rehabilitation. FIM values before PFF, at the beginning of rehabilitation and at its end, and the difference between the beginning and end of rehabilitation were lower in the older group (P<.00001 for all tests). Conclusions: From the functional standpoint, rehabilitation after PFF surgery is much less successful in the 85+ age group than in the 75-to-84 age group but did not differ in its duration, rates of most complications, or mortality. Nonetheless, a significant percentage of patients in this age group have successful rehabilitation so they should not be deprived the chance. © 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Lauritzen JB
        • Schwarz P
        • Lund B
        • McNair P
        • Transbol I.
        Changing incidence and residual lifetime risk of common osteoporosis-related fractures.
        Osteoporos Int. 1993; 3: 127-132
        • Barnes B
        • Dunovan K.
        Functional outcomes after hip fracture.
        Phys Ther. 1987; 67: 1675-1679
        • Broos PL
        • VanHaaflen KI
        • Stappaerts KH
        • Gruwez JA.
        Hip fracture in the elderly. Mortality, functional results and social readaptation.
        Int Surg. 1989; 7: 191-194
        • Folstein MF
        • Folstein SE
        • McHugh PR.
        “Mini-mental state.” A practical method for grading cognitive state of patients for the clinician.
        J Psychiatr Res. 1975; 12: 189-196
        • Sunderland T
        • Hill JL
        • Mellow AM
        • et al.
        Clock drawing in Alzheimer's disease. A novel measure of dementia severity.
        J Am Geriatr Soc. 1989; 37: 725-729
        • Wolf-Klein GP
        • Silverstone FA
        • Levy AP
        • Brod MS
        • Breuer J.
        Screening for Alzheimer's disease by clock drawing.
        J Am Geriatr Soc. 1989; 37: 730-734
        • Yesavage JA
        • Brink TL
        • Rose TL
        • et al.
        Development and validation of a geriatric depression screening scale: a preliminary report.
        J Psychiatr Res. 1983; 17: 37-49
        • Granger CV.
        Health accounting—functional assessment of the long-term patient.
        in: 4th ed. Krusen's handbook of physical medicine and rehabilitation. WB Saunders, Philadelphia1990: 220-228
        • Giaquinto S
        • Majolo I
        • Palma E
        • Roncacci S
        • Sciarra A
        • Vittoria E.
        Very old people can have favorable outcome after hip fracture: 58 patients referred to rehabilitation.
        Arch Gerontol Geriatr. 2000; 31: 13-18
        • Parker MJ
        • Palmer CR.
        Prediction of rehabilitation after hip fracture.
        Age Ageing. 1995; 24: 96-98
        • Lieberman D
        • Fried V
        • Castel H
        • Weitzmann S
        • Lowenthal MN
        • Galinsky D.
        Factors related to successful rehabilitation after hip fracture: a case-control study.
        Dis Rehabil. 1996; 18: 224-230
        • Heruti RJ
        • Lusky A
        • Barell V
        • Ohry A
        • Adunsky A.
        Cognitive status at admission: does it affect rehabilitation outcome of elderly patients with hip fracture?.
        Arch Phys Med Rehabil. 1999; 80: 432-436