Impact of heart failure on functional recovery after hip fracture.
Atsunori Itagaki, Ayaka Kakizaki, Miyuki Funahashi and 3 others
PMID 30936645WHAT IT FOUND
Hip fracture patients with heart failure gained 34.1% of possible daily-living score improvement, versus 51.6% without heart failure, after adjusting for age, gender and pre-fracture walking.
They were also less likely to return to the same residence.
Key findings
01FIM effectiveness was 34.1 ± 38.0% in the heart failure group and 51.6 ± 28.7% in the non-heart failure group, and the difference remained significant after adjustment for age, gender and pre-fracture ambulatory ability (p=0.048).
02Heart failure and pre-fracture ambulatory ability each had significant main effects on FIM effectiveness (p=0.026 and p<0.001), with no significant interaction between them (p=0.240).
03Patients with heart failure were less likely to return to the same residence as before fracture (58.8% vs 81.1%; p=0.039).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Single-center retrospective study from one Japanese convalescent rehabilitation hospital, so results may not generalise to other health systems or acute care settings. The heart failure group was small (17 of 122 patients), which can make estimates unstable. Patients who died in hospital were excluded, so the analysis does not describe those who did not survive to or through rehabilitation. Pre-fracture physical function was assessed only by categorized walking ability (outdoors, indoors, or with assistance or wheelchair), not by continuous measures such as knee extension muscle strength or gait speed. Heart failure etiology and duration between heart failure diagnosis and hip fracture occurrence were not considered.
Declared interests
This research received no grant from any funding agency in the public, commercial or not-for-profit sectors, and the authors declared no conflict of interest.
The easy way to misread this
Do not read this as proof that heart failure causes worse recovery, or that neuromuscular electrical stimulation or branched-chain amino acid supplementation will improve hip fracture rehabilitation. The study observed an association in a retrospective cohort and did not test those treatments.