Prognostic Factors of the Inability to Bear Self-Weight at Discharge in Patients with Fragility Femoral Neck Fracture: A 5-Year Retrospective Cohort Study in Thailand
Abstract
:1. Introduction
2. Methodology
2.1. Study Design
2.2. Data Collection
2.3. Study Endpoint
2.4. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Prognostic Factors of the Inability to Bear Self-Weight at Discharge
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Missing Value n (%) | Unable to Bear Self-Weight at Discharge (n = 55) n (%) | Able to Bear Self-Weight at Discharge (n = 214) n (%) | p-Value | |
---|---|---|---|---|
Sex | 0 (0) | |||
- Male | 19 (34.55) | 57 (26.64) | 0.245 | |
- Female | 36 (65.45) | 157 (73.36) | ||
Age ≥ 80 years | 0 (0) | 27 (49.09) | 100 (46.73) | 0.764 |
BMI ≥ 25 kg/m2 | 3 (1.12) | 8 (14.81) | 41 (19.34) | 0.557 |
Underlying diseases | ||||
- ESRD a | 0 (0) | 11 (20.00) | 13 (6.07) | 0.003 |
- Cirrhosis | 0 (0) | 3 (5.45) | 0 (0) | 0.008 |
- Cerebrovascular diseases | 0 (0) | 10 (18.18) | 17 (7.94) | 0.040 |
- Psychiatric disorders/Drug abuse | 0 (0) | 6 (10.91) | 5 (2.34) | 0.011 |
- Parkinson disease | 0 (0) | 2 (3.64) | 6 (2.80) | 0.668 |
- Diabetes mellitus | 0 (0) | 12 (21.82) | 48 (22.43) | 1.000 |
- Heart diseases | 0 (0) | 12 (21.82) | 36 (16.82) | 0.430 |
- COPD b/Asthma | 0 (0) | 5 (9.09) | 15 (7.01) | 0.571 |
- Eye diseases c | 0 (0) | 4 (7.27) | 16 (7.48) | 1.000 |
- Cancer | 0 (0) | 3 (5.45) | 16 (7.48) | 0.773 |
- Dementia | 0 (0) | 5 (9.09) | 19 (8.88) | 1.000 |
Pre-fracture ambulation status | ||||
- Independent ambulation | 0 (0) | 29 (52.73) | 166 (77.57) | <0.001 |
- Ambulation with gait aids | 0 (0) | 22 (40.00) | 48 (22.43) | |
- Ambulation in wheelchair | 0 (0) | 2 (3.64) | 0 (0) | |
- Non-ambulatory status | 0 (0) | 2 (3.64) | 0 (0) | |
Hypoalbuminemia (<3.5 g/dl) | 45 (16.73) | 23 (50.00) | 48 (26.97) | 0.004 |
Associated fractures | 0 (0) | 10 (18.18) | 2 (0.93) | <0.001 |
Second hip fracture | 0 (0) | 6 (10.91) | 20 (9.35) | 0.798 |
Surgical techniques | ||||
- Arthroplasty d | 0 (0) | 41 (74.55) | 165 (77.10) | 0.722 |
- Fixation e | 0 (0) | 14 (25.45) | 49 (22.90) |
Missing Value n (%) | Unable to Bear Self-Weight at Discharge (n = 55) n (%) | Able to Bear Self-Weight at Discharge (n = 214) n (%) | p-Value | |
---|---|---|---|---|
Intra-operative factors | ||||
Delayed surgery (time from admission to surgery > 48 h) | 0 (0) | 51 (92.73) | 174 (81.31) | 0.042 |
Anesthetic time (hours) a | 0 (0) | 2.17 (1.92, 2.50) | 2.00 (1.75, 2.25) | 0.010 ‡ |
Intra-operative blood loss (ml) a | 0 (0) | 100 (50, 200) | 100 (90, 200) | 0.712 ‡ |
Post-operative factors | ||||
Post-operative ICU admission or ventilator use | 0 (0) | 10 (18.18) | 4 (1.87) | <0.001 |
Major post-operative complications | 0 (0) | 9 (16.36) | 5 (2.34) | <0.001 |
Other operation in admission | 0 (0) | 5 (9.09) | 4 (1.87) | 0.020 |
Post-operative sedative drug use | 0 (0) | 28 (50.91) | 58 (27.10) | 0.001 |
Post-operative blood transfusion | 0 (0) | 18 (32.73) | 50 (23.36) | 0.166 |
Urinary catheter use at post-operative day 2 | 0 (0) | 22 (40.00) | 38 (17.76) | 0.001 |
Moderate to severe pain score at rehabilitation day (PS = 4–10) | 30 (5.78) | 7 (14.29) | 30 (14.56) | 1.000 |
Pressure sore | 0 (0) | 3 (5.45) | 1 (0.47) | 0.028 |
Univariable RR | 95% CI | p-Value | Multivariable RR * | 95% CI | p-Value | |
Male | 1.34 | 0.77–2.34 | 0.302 | 1.49 | 0.83–2.68 | 0.185 |
Age ≥ 80 years | 1.08 | 0.64–1.83 | 0.280 | 0.93 | 0.53–1.62 | 0.793 |
BMI ≥ 25 kg/m2 | 0.80 | 0.38–1.70 | 0.568 | 1.02 | 0.49–2.10 | 0.956 |
Comorbidity | ||||||
- ESRD a | 2.55 | 1.32–4.94 | 0.005 | 2.29 | 1.03–5.10 | 0.042 |
- Cirrhosis | 5.12 | 1.60–16.38 | 0.006 | 3.16 | 1.48–6.76 | 0.003 |
- Cerebrovascular diseases | 1.99 | 1.00–3.95 | 0.049 | 2.68 | 1.32–5.43 | 0.006 |
- Psychiatric disorders/Drug abuse | 2.87 | 1.23–6.70 | 0.015 | 2.02 | 0.93–4.35 | 0.074 |
- Parkinson disease | 0.98 | 0.27–3.55 | 0.977 | 1.06 | 0.48–2.34 | 0.880 |
- Diabetes mellitus | 0.97 | 0.51–1.84 | 0.931 | 1.13 | 0.63–2.02 | 0.691 |
- Heart diseases | 1.28 | 0.68–2.44 | 0.443 | 0.90 | 0.49–1.63 | 0.721 |
- COPD b/Asthma | 1.25 | 0.50–3.12 | 0.640 | 1.36 | 0.57–3.21 | 0.489 |
- Eye diseases c | 0.98 | 0.35–2.70 | 0.963 | 1.35 | 0.59–3.06 | 0.480 |
- Cancer | 0.76 | 0.24–2.43 | 0.643 | 0.85 | 0.26–2.78 | 0.783 |
- Dementia | 1.02 | 0.41–2.56 | 0.965 | 1.27 | 0.52–3.09 | 0.600 |
Pre-fracture ambulation status | ||||||
- Independent ambulation | Ref. | |||||
- Ambulation with gait aids | 2.11 | 1.21–3.68 | 0.008 | 1.63 | 1.02–2.61 | 0.040 |
- Ambulation in wheelchair | 6.72 | 1.60–28.18 | 0.009 | 4.45 | 0.96–20.65 | 0.056 |
- Non-ambulatory status | 6.72 | 1.60–28.18 | 0.009 | 11.18 | 5.86–21.32 | <0.001 |
Hypoalbuminemia | 2.11 | 1.24–3.58 | 0.006 | 1.61 | 0.92–2.79 | 0.094 |
Associated fractures | 4.76 | 2.40–9.44 | <0.001 | 3.75 | 1.99–7.07 | <0.001 |
Second hip fracture | 1.14 | 0.49–2.67 | 0.755 | 1.09 | 0.59–2.02 | 0.784 |
Fixation surgery | 1.12 | 0.61–2.05 | 0.722 | 1.66 | 0.94–2.93 | 0.081 |
Univariable RR | 95% CI | p-Value | Multivariable RR * | 95% CI | p-Value | |
---|---|---|---|---|---|---|
Delayed surgery (time from admission to surgery > 48 h) | 2.49 | 0.90–6.90 | 0.078 | 1.63 | 0.61–4.34 | 0.325 |
Anesthetic time (every 1 h) | 1.47 | 1.02–2.12 | 0.037 | 0.87 | 0.66–1.15 | 0.332 |
Intra-operative blood loss (every 100 mL) | 1.13 | 0.97–1.31 | 0.108 | 1.11 | 1.03–1.19 | 0.008 |
Univariable RR | 95% CI | p-Value | Multivariable RR * | 95% CI | p-Value | |
---|---|---|---|---|---|---|
Post-operative ICU admission or ventilator use | 4.05 | 2.04–8.03 | <0.001 | 1.72 | 0.76–3.85 | 0.191 |
Major post-operative complications | 3.56 | 1.74–7.28 | <0.001 | 1.06 | 0.45–2.52 | 0.896 |
Other operation in admission | 2.89 | 1.15–7.24 | 0.024 | 0.62 | 0.26–1.46 | 0.272 |
Post-operative sedative drug used | 2.21 | 1.30–3.74 | 0.003 | 1.19 | 0.68–2.10 | 0.547 |
Post-operative blood transfusion | 1.44 | 0.82–2.53 | 0.206 | 1.26 | 0.77–2.04 | 0.357 |
Urinary catheter use at post-operative day 2 | 2.32 | 1.35–3.98 | 0.002 | 1.42 | 0.91–2.21 | 0.126 |
Moderate to severe pain at rehabilitation day | 0.86 | 0.34–2.16 | 0.749 | 1.31 | 0.67–2.55 | 0.435 |
Pressure sore | 3.82 | 1.19–12.24 | 0.024 | 3.22 | 1.45–7.13 | 0.004 |
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Tangchitphisut, P.; Khorana, J.; Phinyo, P.; Patumanond, J.; Rojanasthien, S.; Apivatthakakul, T. Prognostic Factors of the Inability to Bear Self-Weight at Discharge in Patients with Fragility Femoral Neck Fracture: A 5-Year Retrospective Cohort Study in Thailand. Int. J. Environ. Res. Public Health 2022, 19, 3992. https://doi.org/10.3390/ijerph19073992
Tangchitphisut P, Khorana J, Phinyo P, Patumanond J, Rojanasthien S, Apivatthakakul T. Prognostic Factors of the Inability to Bear Self-Weight at Discharge in Patients with Fragility Femoral Neck Fracture: A 5-Year Retrospective Cohort Study in Thailand. International Journal of Environmental Research and Public Health. 2022; 19(7):3992. https://doi.org/10.3390/ijerph19073992
Chicago/Turabian StyleTangchitphisut, Paween, Jiraporn Khorana, Phichayut Phinyo, Jayanton Patumanond, Sattaya Rojanasthien, and Theerachai Apivatthakakul. 2022. "Prognostic Factors of the Inability to Bear Self-Weight at Discharge in Patients with Fragility Femoral Neck Fracture: A 5-Year Retrospective Cohort Study in Thailand" International Journal of Environmental Research and Public Health 19, no. 7: 3992. https://doi.org/10.3390/ijerph19073992