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Association Between Orthostatic Hypotension and Handgrip Strength With Successful Rehabilitation in Elderly Hip Fracture Patients

Published:December 16, 2016DOI:https://doi.org/10.1016/j.apmr.2016.11.009

      Abstract

      Objective

      To investigate the relationship between orthostatic hypotension (OH) and muscle strength versus time to successful rehabilitation within elderly patients with hip fracture.

      Design

      A prospective, observational cohort study. Handgrip strength was measured at the day of admission and OH as soon as possible after surgery. Cox proportional hazard modeling was used to investigate the relationship between OH or handgrip strength (kg) and time to successful rehabilitation, expressed as hazard ratios (HRs). OH was defined as a decrease in systolic blood pressure of ≥20mmHg or diastolic blood pressure of ≥10mmHg after postural change (dichotomous). Handgrip strength was measured with a hand dynamometer (continuous).

      Setting

      General hospital.

      Participants

      Patients (N=116) aged ≥70 years with a hip fracture were recruited on the day of hospital admission.

      Interventions

      Not applicable.

      Main Outcome Measures

      Primary outcome was time to successful rehabilitation, which was defined as discharge to patients' own homes.

      Results

      During a median follow-up period of 36 days (interquartile range, 9–57d), 103 patients (89%) were successfully rehabilitated. No statistically significant relationships were found between OH and time to successful rehabilitation (HR=1.05; 95% confidence interval [CI], .67–1.66). Also, handgrip strength and successful rehabilitation were not statistically significantly related (HR=1.03; 95% CI, .99–1.06).

      Conclusions

      OH measured during the first days of hospitalization is not related to time to successful rehabilitation in patients with hip fracture who have undergone surgery. Although no significant relationship was seen in the present study, the width of the CIs does not exclude a relevant relationship between handgrip strength and time to successful rehabilitation.

      Keywords

      List of abbreviations:

      BMI (body mass index), CI (confidence interval), DM (diabetes mellitus), FOF (fear of falling), HR (hazard ratio), IQR (interquartile range), OH (orthostatic hypotension), SBP (systolic blood pressure)
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