Preinjury Factors that Influence the Outcome of Patients with Hip Fracture

Background: The question of whether patients with hip fracture can be discharged home or require hospital transfer for additional rehabilitation is critical. The same clinical pathway is not suitable for all patients. However, there are no clear indices for establishing the appropriate clinical pathway. To address this, we examined preinjury factors, including the Barthel index (BI), and performed logistic regression analysis to identify factors affecting the outcome (direct home discharge or hospital transfer) of patients with hip fracture. Materials and methods: Patients with hip fracture who underwent surgery at Yokohama City University hospital were consecutively enrolled, and clinical data were retrospectively reviewed. Intergroup (direct home discharge or hospital transfer) comparison was performed using Student’s t test (continuous variables) and Fisher’s exact test (categorical variables). Factors affecting outcome were determined by logistic regression analysis. Receiver operating characteristic (ROC) curve analysis was used to identify the cut-off level, sensitivity, and specificity of the identified factors. Results: The preinjury BI scores for patients discharged home directly were significantly higher (p 79 were difficult to discharge directly home and were more likely to be transferred to another hospital (95.6% sensitivity and 62.9% specificity). Conclusions: Low preinjury BI scores ( 79) indicate a requirement for a co-operative pathway between regional hospitals that ensures a smooth hospital transfer.