PREDICTORS OF FUNCTIONAL RECOVERY AFTER HIP FRACTURE IN THE ELDERLY

Three hundred thirty-eight community dwelling, ambulatory, elderly pat ients who sustained a hip fracture were observed prospectively to dete rmine which patient and fracture characteristics at hospital admission predicted functional recovery at 3, 6, and 12 months, Multiple logist ic regression was performed to estimate the simultaneous contributions of the predictor variables to failure of functional recovery. Before sustaining a fracture, 16% of patients were dependent on basic activit ies of daily living and 46% were dependent on instrumental activities of daily living, By 1 year after fracture, 73% of the patients had rec overed to their basic activities of daily living status before fractur e whereas only 48% had recovered to their instrumental activities of d aily living status before fracture, Patients who were age 85 gears or older, who li red alone before sustaining a fracture, and who had one or more comorbidities were at increased risk of delay or failure in re covering basic activities of daily living, Only instrumental activitie s of daily living independence before fracture predicted failure to re cover instrumental activities of daily living function by 3 and 6 mont hs after fracture, At 1 year, patient age 85 years or older was the on ly predictor of failure to recover instrumental activities of daily li ving function that existed before fracture, Based on characteristics a t admission, a group of patients at high risk for failure to recover b asic activities of daily living function within 1 year of sustaining a hip fracture can be identified.