New scoring system at admission to predict walking ability at discharge for patients with hip fracture

Takayoshi Oba, Hiroyuki Makita, Yutaka Inaba, Hayato Yamana, Tomoyuki Saito

Research output: Contribution to journalArticle

Abstract

Introduction: A reliable scoring system that predicts the walking ability of hip fracture patients would be useful for clinicians. Here we developed a scoring system for hip fracture patients and evaluated its predictive ability. Hypothesis: We hypothesized that age, sex, presence of dementia, walking ability before the injury, fracture type, serum hemoglobin level, serum albumin level and interval in days between admission and surgery would be the predictive factors of the walking ability at discharge. Material and methods: Data from 409 patients who underwent hip fracture surgery were included. We analyzed factors that affected walking ability and developed a scoring system that predicts the probability of walking unaided or with a cane at discharge. Results: The mean age of the patients was 81.3 years. A total of 164 (40%) patients could walk unaided or with a cane at discharge. Multivariate logistic regression analysis showed that the obstructive factors for the ability to walk unaided or with a cane at discharge were older age (odds ratio [OR] = 0.962, p = 0.002), dementia (OR = 0.126, p < 0.001), use of a cane before injury (OR = 0.396, p < 0.001), trochanteric fracture (OR = 0.571, p = 0.027) and low serum albumin level (OR = 4.15, p < 0.001) at admission. The scoring system used the following formula: Score = 5 − 0.04 × age + albumin − 2 (with dementia) − 1 (with use of a cane before injury) − 1 (with trochanteric fracture). The C-statistics for the scoring system was 0.81 (95% confidence interval, 0.77–0.85). Discussion: This newly developed scoring system of information at admission predicted the discharge mobility of hip fracture patients. In addition to the previously known risk factors, serum albumin level at admission was detected as a new predictor for mobility at discharge. Level of proof: IV, retrospective study.

Original languageEnglish
JournalOrthopaedics and Traumatology: Surgery and Research
DOIs
Publication statusAccepted/In press - 2018 Jan 1
Externally publishedYes

Fingerprint

Aptitude
Patient Discharge
Hip Fractures
Canes
Walking
Odds Ratio
Serum Albumin
Dementia
Wounds and Injuries
Information Systems
Albumins
Hemoglobins
Retrospective Studies
Logistic Models
Regression Analysis
Confidence Intervals
Serum

Keywords

  • Albumin
  • Hip fracture
  • Predictive factors
  • Scoring system
  • Walking ability

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

New scoring system at admission to predict walking ability at discharge for patients with hip fracture. / Oba, Takayoshi; Makita, Hiroyuki; Inaba, Yutaka; Yamana, Hayato; Saito, Tomoyuki.

In: Orthopaedics and Traumatology: Surgery and Research, 01.01.2018.

Research output: Contribution to journalArticle

@article{e96dca8be406486a8365ca3dd44c83d3,
title = "New scoring system at admission to predict walking ability at discharge for patients with hip fracture",
abstract = "Introduction: A reliable scoring system that predicts the walking ability of hip fracture patients would be useful for clinicians. Here we developed a scoring system for hip fracture patients and evaluated its predictive ability. Hypothesis: We hypothesized that age, sex, presence of dementia, walking ability before the injury, fracture type, serum hemoglobin level, serum albumin level and interval in days between admission and surgery would be the predictive factors of the walking ability at discharge. Material and methods: Data from 409 patients who underwent hip fracture surgery were included. We analyzed factors that affected walking ability and developed a scoring system that predicts the probability of walking unaided or with a cane at discharge. Results: The mean age of the patients was 81.3 years. A total of 164 (40{\%}) patients could walk unaided or with a cane at discharge. Multivariate logistic regression analysis showed that the obstructive factors for the ability to walk unaided or with a cane at discharge were older age (odds ratio [OR] = 0.962, p = 0.002), dementia (OR = 0.126, p < 0.001), use of a cane before injury (OR = 0.396, p < 0.001), trochanteric fracture (OR = 0.571, p = 0.027) and low serum albumin level (OR = 4.15, p < 0.001) at admission. The scoring system used the following formula: Score = 5 − 0.04 × age + albumin − 2 (with dementia) − 1 (with use of a cane before injury) − 1 (with trochanteric fracture). The C-statistics for the scoring system was 0.81 (95{\%} confidence interval, 0.77–0.85). Discussion: This newly developed scoring system of information at admission predicted the discharge mobility of hip fracture patients. In addition to the previously known risk factors, serum albumin level at admission was detected as a new predictor for mobility at discharge. Level of proof: IV, retrospective study.",
keywords = "Albumin, Hip fracture, Predictive factors, Scoring system, Walking ability",
author = "Takayoshi Oba and Hiroyuki Makita and Yutaka Inaba and Hayato Yamana and Tomoyuki Saito",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.otsr.2018.07.024",
language = "English",
journal = "Orthopaedics and Traumatology: Surgery and Research",
issn = "1877-0568",
publisher = "Elsevier Masson",

}

TY - JOUR

T1 - New scoring system at admission to predict walking ability at discharge for patients with hip fracture

AU - Oba, Takayoshi

AU - Makita, Hiroyuki

AU - Inaba, Yutaka

AU - Yamana, Hayato

AU - Saito, Tomoyuki

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Introduction: A reliable scoring system that predicts the walking ability of hip fracture patients would be useful for clinicians. Here we developed a scoring system for hip fracture patients and evaluated its predictive ability. Hypothesis: We hypothesized that age, sex, presence of dementia, walking ability before the injury, fracture type, serum hemoglobin level, serum albumin level and interval in days between admission and surgery would be the predictive factors of the walking ability at discharge. Material and methods: Data from 409 patients who underwent hip fracture surgery were included. We analyzed factors that affected walking ability and developed a scoring system that predicts the probability of walking unaided or with a cane at discharge. Results: The mean age of the patients was 81.3 years. A total of 164 (40%) patients could walk unaided or with a cane at discharge. Multivariate logistic regression analysis showed that the obstructive factors for the ability to walk unaided or with a cane at discharge were older age (odds ratio [OR] = 0.962, p = 0.002), dementia (OR = 0.126, p < 0.001), use of a cane before injury (OR = 0.396, p < 0.001), trochanteric fracture (OR = 0.571, p = 0.027) and low serum albumin level (OR = 4.15, p < 0.001) at admission. The scoring system used the following formula: Score = 5 − 0.04 × age + albumin − 2 (with dementia) − 1 (with use of a cane before injury) − 1 (with trochanteric fracture). The C-statistics for the scoring system was 0.81 (95% confidence interval, 0.77–0.85). Discussion: This newly developed scoring system of information at admission predicted the discharge mobility of hip fracture patients. In addition to the previously known risk factors, serum albumin level at admission was detected as a new predictor for mobility at discharge. Level of proof: IV, retrospective study.

AB - Introduction: A reliable scoring system that predicts the walking ability of hip fracture patients would be useful for clinicians. Here we developed a scoring system for hip fracture patients and evaluated its predictive ability. Hypothesis: We hypothesized that age, sex, presence of dementia, walking ability before the injury, fracture type, serum hemoglobin level, serum albumin level and interval in days between admission and surgery would be the predictive factors of the walking ability at discharge. Material and methods: Data from 409 patients who underwent hip fracture surgery were included. We analyzed factors that affected walking ability and developed a scoring system that predicts the probability of walking unaided or with a cane at discharge. Results: The mean age of the patients was 81.3 years. A total of 164 (40%) patients could walk unaided or with a cane at discharge. Multivariate logistic regression analysis showed that the obstructive factors for the ability to walk unaided or with a cane at discharge were older age (odds ratio [OR] = 0.962, p = 0.002), dementia (OR = 0.126, p < 0.001), use of a cane before injury (OR = 0.396, p < 0.001), trochanteric fracture (OR = 0.571, p = 0.027) and low serum albumin level (OR = 4.15, p < 0.001) at admission. The scoring system used the following formula: Score = 5 − 0.04 × age + albumin − 2 (with dementia) − 1 (with use of a cane before injury) − 1 (with trochanteric fracture). The C-statistics for the scoring system was 0.81 (95% confidence interval, 0.77–0.85). Discussion: This newly developed scoring system of information at admission predicted the discharge mobility of hip fracture patients. In addition to the previously known risk factors, serum albumin level at admission was detected as a new predictor for mobility at discharge. Level of proof: IV, retrospective study.

KW - Albumin

KW - Hip fracture

KW - Predictive factors

KW - Scoring system

KW - Walking ability

UR - http://www.scopus.com/inward/record.url?scp=85054168993&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85054168993&partnerID=8YFLogxK

U2 - 10.1016/j.otsr.2018.07.024

DO - 10.1016/j.otsr.2018.07.024

M3 - Article

C2 - 30293749

AN - SCOPUS:85054168993

JO - Orthopaedics and Traumatology: Surgery and Research

JF - Orthopaedics and Traumatology: Surgery and Research

SN - 1877-0568

ER -