Walking It Off: Early Walking Predicts Short-Term Results from Hip SurgeryThe cost of health care has gone steadily up in the last 10 years. Hospitals must do their best to provide good treatment in as little time as possible. This often means sending a patient home soon after surgery. Going home after surgery requires that the patient is medically stable. The patient must also be able to walk and move without help.
Often hospital staff are already planning the patient's discharge before surgery even begins. How is this possible? Do they have a crystal ball to show how well someone will do? No, they use a set of "predictors." In the case of hip fracture, age, mental state, and the ability to get around before fracture predict how well someone will do in the early days after surgery.
Many studies have identified factors that don't predict how well someone will do after surgery. These factors include type of surgery, type of anesthesia, side of fracture, education level, and country of origin. Researchers keep trying to find new factors that will help with discharge planning. A recently identified factor is the ability to move around the first few days after surgery.
Researchers in Australia found that mobility two days after surgery is a very reliable measure of short-term ability. Patients who could get up and walk by day two were able to go home at the end of their hospital stays. Patients who were not able to walk by day two had to consider other options such as discharge to a rehab clinic or nursing home.
When an older adult has a hip fracture, it is very helpful to know how to plan for his or her recovery from surgery. How well the patient can walk in the first two days after surgery is a good predictor of short-term results. This kind of information helps hospital staff and other caregivers plan for the patient's release from the hospital. Sometimes it's necessary to arrange for extra care at home or a middle step before returning home. Knowing who will need this extra care can help caregivers plan for the best possible recovery.
Ross G. Duke, BAppSc (Physio) (CSwk), and Jennifer L. Keating, PhD. An Investigation of Factors Predictive of Independence in Transfers and Ambulation After Hip Fracture. In Archives of Physical Medicine and Rehabilitation. February 2002. Vol. 83. No. 2. Pp. 158-164.
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