Randomised, clinically controlled trial of intensive geriatric rehabilitation in patients with hip fracture: subgroup analysis of patients with dementia
- 4 November 2000
- Vol. 321 (7269), 1107-1111
- https://doi.org/10.1136/bmj.321.7269.1107
Abstract
Objective: To evaluate the effect of intensive geriatric rehabilitation on demented patients with hip fracture. Design: Preplanned subanalysis of randomised intervention study. Settting: Jyväskylä Central Hospital, Finland. Participants: 243 independently living patients aged 65 years or older admitted to hospital with hip fracture. Intervention: After surgery patients in the intervention group (n=120) were referred to the geriatric ward whereas those in the control group were discharged to local hospitals. Main outcome measures: Length of hospital stay, mortality, and place of residence three months and one year after surgery for hip fracture. Results: The median length of hospital stay of hip fracture patients with moderate dementia (mini mental state examination score 12-17) was 47 days in the intervention group (n=24) and 147 days in the control group (n=12, P=0.04). The corresponding figures for patients with mild dementia (score 18-23) were 29 days in the intervention group (n=35) and 46.5 days in the control group (n=42, P=0.002). Three months after the operation, in the intervention group 91% (32) of the patients with mild dementia and 63% (15) of the patients with moderate dementia were living independently. In the control group, the corresponding figures were 67% (28) and 17% (2). There were no significant differences in mortality or in the lengths of hospital stay of severely demented patients and patients with normal mini mental state examination scores. Conclusions: Hip fracture patients with mild or moderate dementia can often return to the community if they are provided with active geriatric rehabilitation.This publication has 34 references indexed in Scilit:
- Prediction of Rehabilitation after Hip FractureAge and Ageing, 1995
- Comprehensive geriatric assessment: a meta-analysis of controlled trialsThe Lancet, 1993
- How predictable is rehabilitation after hip fracture?: A prospective study of 134 patientsActa Orthopaedica, 1991
- Morbidity and Mortality following Fractures of the Femoral Neck and Trochanteric RegionJournal Of Trauma-Injury Infection and Critical Care, 1989
- Prospective randomised study of an orthopaedic geriatric inpatient service.BMJ, 1988
- Effectiveness of geriatric rehabilitative care after fractures of the proximal femur in elderly women: a randomised clinical trial.BMJ, 1988
- Reducing acute confusional states in elderly patients with hip fracturesResearch in Nursing & Health, 1985
- “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinicianJournal of Psychiatric Research, 1975
- Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily LivingThe Gerontologist, 1969
- Studies of Illness in the AgedPublished by American Medical Association (AMA) ,1963