Effects of geriatric interdisciplinary home rehabilitation on complications and readmissions after hip fracture: a randomized controlled trial.
Monica Berggren, Åsa Karlsson, Nina Lindelöf and 5 others
PMID 30064264WHAT IT FOUND
Older adults with hip fracture who received conventional geriatric care plus home rehabilitation had similar complications and readmissions as those who received conventional geriatric care.
Adding home rehabilitation did not reduce complications, readmissions, or days in hospital after discharge.
Key findings
01Complications after discharge occurred in 57 of 106 intervention participants and 44 of 93 control participants, with no significant difference.
02Subgroup analyses by housing and fracture type found no difference in complications, readmissions, or days spent in hospital after discharge.
03From discharge to 12 months, 46 of 106 intervention participants and 38 of 93 control participants fell, and the adjusted fall risk did not differ.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This was a secondary analysis, and the study had limited statistical power for complications, so a real difference could have been missed. Randomization did not fully balance the groups: analgesic, antidepressant, and Parkinson medication prescriptions differed at baseline. Ward staff and the geriatrician registering complications were not blinded to group allocation. The intervention was conventional geriatric care plus home rehabilitation, so the study cannot isolate the effect of home rehabilitation alone. Seven participants randomized to home rehabilitation did not receive it, although they were still analysed. Falls may have been undercounted because fall calendars were not used and many participants had cognitive impairment. Only people with trochanteric fracture who needed longer hospital rehabilitation were eligible, which may limit generalizability. The analysis used 106 intervention and 93 control participants, while 205 were included overall.
Declared interests
The authors declared no potential conflicts of interest. Funding was from the University of Umeå, County Council of Västerbotten, the Foundation of the Medical Faculty, the Swedish Dementia Association, the Swedish Research Council, and the Strategic Research Program in Care Sciences.
The easy way to misread this
Do not conclude that home rehabilitation is useless or harmful. This analysis found similar complications and readmissions compared with conventional geriatric care, and the study had limited statistical power for complications.