Comparative Assessment of Quality of Life in Hip Fracture Patients Before and After Surgery: A Prospective Longitudinal Observational Study.

Abstract

Background and Objectives: Hip fractures are a leading cause of morbidity in the elderly, often resulting in declining physical function, psychological distress, and diminished quality of life (QoL). This study aimed to evaluate changes in QoL among hip fracture patients preoperatively and postoperatively, comparing diverse patient subgroups to identify factors influencing recovery. Methods: We conducted a prospective longitudinal observational study at Victor Babeș University of Medicine and Pharmacy Timișoara, recruiting 77 adult patients admitted for surgical management of hip fractures between March 2023 and March 2025. Standardized questionnaires, including the Short Form-36 (SF-36), World Health Organization Quality of Life (WHOQOL-BREF), Hospital Anxiety and Depression Scale (HADS), and Generalized Anxiety Disorder-7 (GAD-7), were administered preoperatively and at 3 months postoperatively. Demographic, clinical, and surgical variables were also recorded. Results: Participants' mean age was 72.6 years (SD 8.1), with 57.1% female. Postoperative QoL scores (SF-36 Physical Function domain mean 52.7 ± 9.2) improved significantly compared to preoperative scores (44.8 ± 8.7, p = 0.012). WHOQOL-BREF physical and psychological domain scores similarly increased (p < 0.05). Anxiety and depression symptoms, as measured by HADS and GAD-7, decreased markedly postoperatively in most subgroups. Subgroup analyses revealed that patients undergoing total hip arthroplasty demonstrated more pronounced QoL improvements than those receiving partial hip replacement. Older patients (≥80 years) exhibited improvements but at a slower rate. Conclusions: Quality of life indicators show notable improvement following surgical treatment of hip fractures, underscoring the significance of timely orthopedic intervention and comprehensive perioperative care. Anxiety and depression levels also declined, highlighting the benefits of a structured follow-up. These findings may guide clinicians toward optimizing patient-centered recovery protocols and targeted interventions, particularly for older adults or those with high baseline anxiety and depression levels.