MOBILITY AFTER HIP FRACTURE PREDICTS HEALTH OUTCOMES

OBJECTIVES: Balance and gait are essential to physical functioning and the performance of activities of daily living. The objective of this study was to determine the predictive value of a balance and gait test on subsequent mortality, morbidity, and healthcare utilization among older hip fracture patients. DESIGN: A prospective study of hip fractu re recovery. SETTING: Patients with a new hip fracture admitted from t he community to one of eight Baltimore hospitals and followed in their homes for 2 years postfracture. PARTICIPANTS: A total of 306 patients with hip fracture, 65 years of age and older, who completed a gait an d balance assessment at 2 months postfracture. MEASUREMENTS: The relat ionship between gait and balance test performance at 2 months postfrac ture and mortality, physician visits, rehospitalizations, nursing home placement, and falls up to 24 months postfracture was assessed by Cox proportional hazards and least squares regression. RESULTS: After adj usting for age, sex, race, and comorbidity, the balance score and the summary mobility score predicted mortality. A 17% increase in the risk of mortality was demonstrated for each unit decrease in the balance s core (range 0-17), and a 10% increase was demonstrated for each decrea se in the summary score (range 0-26). Unsteady balance during immediat e standing, turning, sitting down, and rising from a chair were associ ated significantly with increased mortality. Poor balance, but not poo r gait, was associated with an increase in hospitalizations up to 24 m onths postfracture. Both poor balance and poor gait were associated wi th nursing home placement, with 20% and 17% increased odds, respective ly. Mobility did not predict future physician visits or falls.CONCLUSI ONS: These findings demonstrate that balance and gait are predictive o f future health outcomes for older hip fracture patients.