Predictors of mobility status one year post hip fracture among community-dwelling older adults prior to fracture: A prospective cohort study.

التفاصيل البيبلوغرافية
العنوان:	Predictors of mobility status one year post hip fracture among community-dwelling older adults prior to fracture: A prospective cohort study.
المؤلفون:	Bajracharya R; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.; Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany., Guralnik JM; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA., Shardell MD; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA., Hochberg MC; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA., Orwig DL; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA., Magaziner JS; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.
المصدر:	Journal of the American Geriatrics Society [J Am Geriatr Soc] 2023 Aug; Vol. 71 (8), pp. 2441-2450. Date of Electronic Publication: 2023 Mar 14.
نوع المنشور:	Journal Article; Research Support, N.I.H., Extramural
اللغة:	English
بيانات الدورية:	Publisher: Blackwell Science Country of Publication: United States NLM ID: 7503062 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-5415 (Electronic) Linking ISSN: 00028614 NLM ISO Abbreviation: J Am Geriatr Soc Subsets: MEDLINE
أسماء مطبوعة:	Publication: Malden, MA : Blackwell Science Original Publication: New York [etc.]
مواضيع طبية MeSH:	Independent Living* , Hip Fractures*, Male ; Humans ; Aged ; Aged, 80 and over ; Female ; Prospective Studies ; Walking ; Walking Speed
مستخلص:	Background: Orthopedists and other clinicians assess recovery potential of hip fracture patients at 2 months post-fracture for care planning. It is unclear if examining physical performance (e.g., balance, gait speed, chair stand) during this follow-up visit can identify individuals at a risk of poor functional recovery, especially mobility, beyond available information from medical records and self-report. Methods: Data came from 162 patients with hip fracture enrolled in the Baltimore Hip Studies-7th cohort. Predictors of mobility status (ability to walk 1 block at 12 months post-fracture) were the Short Physical Performance Battery (SPPB) comprising balance, walking and chair rise tasks at 2 months; baseline medical chart information (sex, age, American Society of Anesthesiologist physical status rating, type of fracture and surgery, and comorbidities); and self-reported information about the physical function (ability to walk 10 feet and 1 block at pre-fracture and at 2 months post-fracture). Prediction models of 12-month mobility status were built using two methods: (1) logistic regression with least absolute shrinkage and selection operator (LASSO) regularization, and (2) classification and regression trees (CART). Area under ROC curves (AUROC) assessed discrimination. Results: The participants had a median age of 82 years, and 49.3% (n = 80) were men. Two-month SPPB and gait speed were selected as predictors of 12-month mobility by both methods. Compared with an analytic model with medical chart and self-reported information, the model that additionally included physical performance measures had significantly better discrimination for 12-month mobility (AUROC 0.82 vs. 0.88, p = 0.004). Conclusion: Assessing SPPB and gait speed at 2 months after a hip fracture in addition to information from medical records and self-report significantly improves prediction of 12-month mobility. This finding has important implications in providing tailored clinical care to patients at a greater risk of being functionally dependent who would not otherwise be identified using regularly measured clinical markers. (© 2023 The American Geriatrics Society.)
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معلومات مُعتمدة:	P30 AG028747 United States AG NIA NIH HHS; R01 AG079854 United States AG NIA NIH HHS; R56 AG068673 United States AG NIA NIH HHS; R01 AG048069 United States AG NIA NIH HHS; R03 AG070178 United States AG NIA NIH HHS; R37 AG009901 United States AG NIA NIH HHS; T32 AG000262 United States AG NIA NIH HHS; R01 AG029315 United States AG NIA NIH HHS; RF1 NS128360 United States AG NIA NIH HHS; RF1 NS128360 United States NS NINDS NIH HHS
فهرسة مساهمة:	Keywords: CART; SPPB; activities of daily living limitations; gait speed; mobility
تواريخ الأحداث:	Date Created: 20230314 Date Completed: 20230807 Latest Revision: 20240802
رمز التحديث:	20240802
مُعرف محوري في PubMed:	PMC10440300
DOI:	10.1111/jgs.18327
PMID:	36918363
قاعدة البيانات:	MEDLINE

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تدمد:	1532-5415
DOI:	10.1111/jgs.18327