Objective:

To assess the relationship between mobility recovery after hip fracture surgery and mortality risk.

Approach:

• Study Design: Nationwide cohort study analyzing data from 33,486 patients aged 65 and older who underwent surgery for first-time unilateral low-energy hip fractures between January 2016 and November 2021.
• Mobility Assessment: Mobility was assessed using the Cumulated Ambulation Score, measuring independence in various mobility tasks.
• Outcomes: Primary outcomes included reoperation rates within 30 days and 1 year, while secondary outcomes focused on all-cause mortality at the same time points.

Key Findings:

• 65% of patients did not regain prefracture mobility by discharge.
• 30-day mortality was 9% for those who did not regain mobility versus 3% for those who did, with failure to regain mobility associated with about twice the likelihood of mortality within 30 days.
• At 1 year, mortality was 29% for patients who did not regain mobility compared to 12% for those who did.
• A dose-response relationship was observed, with increased mortality correlating with greater mobility loss.
• Mobility recovery was not consistently linked to reoperation risk.

Interpretation:

Limitations:

• The observational nature of the study limits causal inferences.
• Factors such as frailty, comorbidity, and postoperative complications may confound the relationship between mobility and mortality.
• Decisions regarding reoperation may be influenced by competing mortality risks and treatment preferences.

Conclusion:

Sources:

• Acta Orthopaedica