Research Abstract: Free Paper - Oral Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2023

Patient and hospital factors influencing the ability to mobilise day 1 after hip fracture surgery (#37)

Victoria Woodcroft-Brown 1 , Jack Bell 2 , Chrysanth Pulle 1 , Rebecca Mitchell 3 , Jacqueline Close 4 5 , Catherine McDougall 1 , Sarah Hurring 6 , Mitchell Sarkies 3
  1. The Prince Charles Hospital, Metro North Hospital and Health Service, Chermside, QLD, Australia
  2. The Prince Charles Hospital Allied Health Research Collaborative (AHRC), The Prince Charles Hospital, Chermside, QLD, Australia
  3. Australian Institute of Health Innovation, Faculty of Medicine, Macquarie University, Sydney, NSW, Australia
  4. Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, NSW, Australia
  5. School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
  6. Older Person's Health Specialist Service, Te Whatu Ora Waitaha, Canterbury, New Zealand

Aims: Compare patient demographics, injury characteristics, and hospital processes for older adults with surgically-managed hip fractures and examine predictors of actual first day mobilisation.

Methods: A retrospective cohort study was conducted using data from the Australian and New Zealand Hip Fracture Registry between 1st January 2020 to 31st December 2020. Multivariable logistic regression was used to examine factors associated with actual first day mobilisation postoperatively.

Results: Of 14,209 hip fracture patients, 5,981 (42.1%) mobilised day 1 and 6,337 (44.6%) did not mobilise day 1. Surgery delay more than 48 hours (OR 0.83, 95% CI 0.75-0.93), hemiarthroplasty procedure (OR 0.54, 95% CI 0.44-0.67) and restricted/non-weight bearing status post-operatively (OR 0.47, 95% CI 0.38-0.58) were predictors of reduced odds of mobilisation day 1 post surgery. Odds of actual first day mobilisation were higher for individuals assessed as ‘no delirium’ (OR 1.40, 95% CI 1.26-1.56) or ‘not malnourished’ (OR 1.13, 95% CI 1.02-1.26), who were provided the opportunity to mobilise (OR 45.61, 95% CI 29.96-69.41) or where the consultant surgeon was present during the operation (OR 1.08, 95% CI 0.99-1.18). Hospitals with annual hip fracture volume 151-200 patients (OR 1.10, 95% CI 0.91-1.33), geriatric or medical consult service on referral or another model (OR 1.39, 95% CI 1.14-1.70), or routine access to therapy services on weekends (OR 1.79, 95% CI 1.45-2.21) had higher odds of actual first day mobilisation.

Conclusions: Patient and hospital factors influence first day mobilisation post hip fracture surgery. Optimization of modifiable factors should be prioritized to improve post-operative mobilisation.