Determinants of rehabilitation following fracture of the hip in elderly patients

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Abstract
The objective of the study was to explore the relationships between rehabilitation outcomes in elderly patients admitted to a rehabilitation hospital following a surgically treated hip fracture and independent variables. Prefracture function, and independent patients' variables and particulars regarding the fracture were recorded. Functional and mental status as well as motivation and co-operativeness were assessed on admission to rehabilitation, during rehabilitation and six months after discharge. Data were transferred to structured questionnaires for analysis. A total of 112 patients with a mean age of 74.8 years, made up of 75% females and 25% males, were admitted consecutively for rehabilitation after a surgically treated hip fracture sustained in a fall, during a two-year period (1989-91). Of these, 11 patients (9.8 per cent) died during rehabilitation; 86% of the 101 survivors returned to their prefracture residence, but 25% of survivors had not attained their prefracture functional status by discharge. Motivation, co-operativeness and unimpaired mental function on admission to rehabilitation were found to be the most important determinants of satisfactory outcomes. It was concluded that attention should be paid to the elderly person who has sustained the fracture and not only to the fracture itself. Motivation and co- operativeness should be constantly monitored during the rehabilitation process.