Predictors of Functional Recovery and Poor Clinical Outcomes Following Hip Fracture Surgery in Older Adults: A Prospective Cohort Study at Mayo Hospital Lahore
DOI:
https://doi.org/10.61919/jhrr.v6i4.2001Keywords:
Hip fracture, older adults, functional recovery, frailty, rehabilitation, Mayo Hospital Lahore.Abstract
Background: Hip fracture surgery in older adults is frequently followed by incomplete functional recovery and adverse clinical outcomes. Objective: To evaluate predictors of functional recovery and poor clinical outcomes following hip fracture surgery in older adults at Mayo Hospital Lahore. Methods: This prospective cohort study included 154 older adults undergoing hip fracture surgery. Baseline demographic, clinical, psychosocial, perioperative, and rehabilitation-related variables were assessed. Outcomes included poor clinical outcome at follow-up, recovery of pre-fracture mobility, recovery of health-related quality of life, postoperative delirium, 30-day readmission, one-year mortality, Timed Up and Go performance, and functional status score. Predictors of poor outcome were analyzed using odds ratios with 95% confidence intervals. Results: The mean age was 78.6 ± 7.4 years, and 70.8% were female. Poor clinical outcome occurred in 37.7% of patients, while 50.6% recovered pre-fracture mobility and 53.2% recovered pre-fracture health-related quality of life. Frailty was the strongest predictor of poor outcome (OR: 2.84; 95% CI: 1.43–5.64; p=0.003), followed by cognitive impairment (OR: 2.31; p=0.035), depressive symptoms (OR: 2.12; p=0.041), and low social support (OR: 1.96; p=0.047). Rehabilitation adherence (OR: 0.46; p=0.026) and pre-fracture independent ambulation (OR: 0.41; p=0.014) were protective. Conclusion: Functional recovery after hip fracture surgery in older adults is influenced by frailty, cognition, psychological status, social support, rehabilitation adherence, and baseline mobility.
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