• Cornelis L P van de Ree, Maud J F Landers, Nena Kruithof, Leonie de Munter, Slaets Joris P J JPJ Leyden Academy on Vitality and Ageing, Leiden, The Netherlands. Department of Inter, Taco Gosens, and de Jongh Mariska A C MAC Trauma TopCare, Elisabeth-TweeSteden Ziekenhuis, Tilburg, The Netherlands. Brab.
• Trauma TopCare, Elisabeth-TweeSteden Ziekenhuis, Tilburg, The Netherlands.
• BMJ Open. 2019 Jul 18; 9 (7): e025941.

ObjectivesThe aims of this study were to examine the pattern of changes over time in health status (HS) and quality of life (QoL) in the first year after hip fracture and to quantify the association between frailty at the onset of hip fracture and the change in HS and QoL 1 year later. The major hypothesis was that frailty, a clinical state of increased vulnerability, is a good predictor of QoL in patients recovering from hip fracture.DesignProspective, observational, follow-up cohort study.SettingSecondary care. Ten participating centres in Brabant, the Netherlands.Participants1091 patients entered the study and 696 patients completed the study. Patients with a hip fracture aged 65 years and older or proxy respondents for patients with cognitive impairment were included in this study.Main Outcome MeasuresThe primary outcomes were HS (EuroQol-5 Dimensions questionnaire) and capability well-being (ICEpop CAPability measure for Older people). Prefracture frailty was defined with the Groningen Frailty Indicator (GFI), with GFI ≥4 indicating frailty. Participants were followed up at 1 month, 3 months, 6 months and 1 year after hospital admission.ResultsIn total, 371 patients (53.3%) were considered frail. Frailty was negatively associated with HS (β -0.333; 95% CI -0.366 to -0.299), self-rated health (β -21.9; 95% CI -24.2 to -19.6) and capability well-being (β -0.296; 95% CI -0.322 to -0.270) in elderly patients 1 year after hip fracture. After adjusting for confounders, including death, prefracture HS, age, prefracture residential status, prefracture mobility, American Society of Anesthesiologists grading and dementia, associations were weakened but remained significant.ConclusionsWe revealed that frailty is negatively associated with QoL 1 year after hip fracture, even after adjusting for confounders. This finding suggests that early identification of prefracture frailty in patients with a hip fracture is important for prognostic counselling, care planning and the tailoring of treatment.Trial Registration NumberNCT02508675.© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

17 keywords...

hide…