Outcomes of intermediate phase after hip fracture rehabilitation and factors associated with gait recovery in Lampang Hospital
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Abstract
Background Intermediate Care (IMC) is a key public health policy aimed at bridging rehabilitation gaps, especially for elderly hip fracture patients. Delayed or inadequate rehabilitation risks long-term disability. This study analyzes rehabilitation outcomes and factors influencing postoperative gait recovery in hip fracture patients at Lampang Hospital.
Objective To assess intermediate rehabilitation outcomes and identify factors affecting gait recovery after surgery.
Methodology This research is a retrospective study using data from the medical records of hip fracture patients who underwent surgery and received care at Lampang Hospital from 1 January 2022 to 30 June 2023. Patients were categorized into two groups: those who were able to walk and those who were unable to walk. The data analyzed included patient demographics, clinical characteristics, and rehabilitation outcomes, as measured by the Barthel Index (BI) score. Statistical analyses were performed using t-test, chi-square test, Fisher's exact test, and multivariable logistic regression. A significance level of p<0.05 was considered statistically significant.
Results A total of 585 participants were included, with an average age of 76.50 ± 9.13 years, and 73.33% were female. The participants were divided into the walking group (264 patients, 45.10%) and the non-walking group (321 patients, 54.90%). 88.21% of the patients showed an increase in their Barthel Index scores, with the score before rehabilitation at 6.10 ± 2.16 and after rehabilitation at 10.81 ± 4.36, which showed a statistically significant difference (p<0.001). Positive factors influencing patients’ ability to walk again included surgery within 72 hours, pain score lower than 4, and the ability to sit independently before walking training. Negative factors included being over 75 years old, a history of stroke, and postoperative delirium.
Conclusion and Recommendations Rehabilitation significantly enhances functional recovery in hip fracture patients. The factors identified in this study can be used to set rehabilitation goals and determine the intensity of rehabilitation programs tailored to the patient’s status including the ongoing rehabilitation planned for the patients in community phase. Further studies should be conducted to assess other outcomes including quality of life, mental health and the cost-effectiveness in relation to the longer duration of rehabilitation program.
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