A Systematic Review and Meta-Analysis of Barriers Affecting Early Ambulation in Older Patients After Hip Fracture Surgery.

Abstract

Hip fracture is a catastrophic traumatic injury for the older adults, early ambulation is crucial for recovery. Prior researchers explored a number of influencing factors, but there is still a pressing need for synthesizing the evidence. A systematic literature review was conducted for original studies by searching electronic databases included PubMed, Embase, CINAHL, Scopus, web of science and Cochrane Library from inception till July 2023. The odds ratio and 95% confidence interval were calculated for the combined risk factors using Review Manager 5.4. Finally, 2665 articles were initially assessed, and 26 studies were ultimately deemed eligible for inclusion in this meta-analysis, contributing a collective total of 18 698 subjects to the analysis. The following factors were showed strong association with early ambulation: age (OR: 1.04, 95% CI: 1.03-1.05); low pre-fracture functional level (OR: 1.39, 95% CI: 1.25-1.54); anemia (OR: 2.81, 95% CI: 1.79-4.42); vitamin D deficiency (OR: 2.73, 95% CI:1.64-4.56); poor nutritional status (OR:2.08, 95% CI: 1.56-2.77); cognitive impairment (OR: 1.16, 95% CI: 1.09-1.22); Charlson Comorbidity Index (OR: 0.80, 95% CI: 0.72-0.90); intertrochanteric fracture (OR: 3.24, 95% CI: 1.99-5.28). For patients presenting with the aforementioned influencing factors, targeted preventive approaches and management strategies should be employed to facilitate rapid postoperative recovery.