PTOTCohortEuropean journal of physical and rehabilitation medicine2023

Predictive factors for home discharge after femoral fracture surgery: a prospective cohort study.

Intonia H Chow, Tiev Miller, Marco Y Pang

PMID 37750861

WHAT IT FOUND

Female sex, higher preoperative cognition, more physiotherapy sessions, higher exercise self-efficacy, and caregiver availability predicted home discharge after hip fracture surgery.

These factors identified patients likely to return home versus needing institutional care.

Key findings

01Female sex, ≥8 physiotherapy sessions, MMSE score ≥17, SEE score ≥53, and caregiver availability were significant predictors of home discharge in the multivariate model.

02The model correctly classified 77.1% of participants and explained approximately 40% of the variance in discharge destination.

03Greater postoperative exercise self-efficacy was associated with a 5.9-fold higher likelihood of home discharge.

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 study with a small sample size (109 participants), limiting generalizability. More than half of screened patients were excluded, potentially introducing selection bias. The model explained only about 40% of the variance in discharge destination, meaning many factors influencing discharge were not captured. Regional healthcare policies and lack of intermediate discharge options in Hong Kong may limit applicability to other settings. Observational design cannot prove causation; for example, more physiotherapy sessions may reflect better recovery rather than causing home discharge.

Declared interests

The authors declared no conflicts of interest. The study received no specific funding, though manpower and infrastructure support were provided by Queen Elizabeth Hospital.

The easy way to misread this

Do not assume that simply increasing the number of physiotherapy sessions will guarantee home discharge. The study is observational, so the association between more sessions and home discharge may reflect that patients who were recovering well received more therapy, rather than the therapy itself causing the discharge outcome.

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