Authors (including presenting author) :
CHUNG JCL (1), LAU NYN (1), AU ILY (1), CHAN DCM (1), YUNG BPK (1), LEE SKW (1), TIU KL (2), LEE KB (2), CHAN ACM (1)
Affiliation :
(1) Physiotherapy Department, Queen Elizabeth Hospital, (2) Department of Orthopaedics and Traumatology, Queen Elizabeth Hospital
Introduction :
Fragility hip fracture (FHF) is a major public health concern as it is associated with dramatic consequences. Approximately 30% of FHF patients suffered from reduced functional independence while nearly 20% required old-aged home care due to persistent disability. FHF is commonly managed by surgical intervention supplemented by a course of post-operative rehabilitation. It is essential to estimate the prognosis of FHF patients by predicting rehabilitation potential in pre-operative phases. This facilitates practitioners to set realistic objectives for rehabilitation, formulate discharge plan and potentially define care organization. Handgrip strength (HGS) is a cost-effective tool which offers prediction for overall body strength. Nevertheless, insufficient research has explored its utilization as a prognostic factor in FHF patients.
Objectives :
To investigate the relationship among pre-operative HGS, length of stay (LOS) and functional outcomes at 1-year follow up in patients with FHF following surgery.
Methodology :
A retrospective study was conducted. FHF patients admitted to the Queen Elizabeth Hospital (QEH) between April 2017 to March 2021 with age 65 years or above, who have been treated operatively and attended the multidisciplinary fragility fracture clinic at 1-year follow up were evaluated. Patients with repeated transferring history between hospitals were excluded. HGS was measured at pre-operative stage. Post-fracture total LOS was captured from the Clinical Data Analysis and Reporting System (CDARS). Modified Functional Ambulation Classification (MFAC) and Elderly Mobility Scale (EMS) at 1-year follow up were obtained. Correlation between HGS and LOS was analyzed using Pearson’s correlation coefficient. Correlation between HGS and MFAC and EMS were analyzed using Spearman’s rank correlation coefficient.
Result & Outcome :
One hundred and eighty-one patients (mean age=82.7 ± 7.0 years) (46 males, 135 females) were evaluated. Statistically significant negative correlation was found between HGS and LOS (r=-0.174, p=0.019) while positive correlations were found between HGS and MFAC (r=0.262, p<0.001) and EMS (r=0.395, p<0.001). This implied that greater pre-operative HGS is associated with shorter length of hospitalization and superior functional outcomes after 1 year after operation.
HGS is an important prognostic factor in patients with FHF as it facilitates rehabilitation optimization and discharge arrangement. Future research on the predictive effect of HGS on patients’ rehabilitation potential, long-term functional ability and discharge destination are warranted.
