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dc.contributor.authorDyer, Suzanne M
dc.contributor.authorCrotty, Maria
dc.contributor.authorFairhell, N
dc.contributor.authorMagaziner, J
dc.contributor.authorBeaupre, L
dc.contributor.authorCameron, Ian D
dc.contributor.authorSherrington, Catherine
dc.contributor.authorRehabilitation Research Special Interest Group, Fragility Fracture Network (FFN)
dc.date.accessioned2016-10-25T03:18:22Z
dc.date.available2016-10-25T03:18:22Z
dc.date.issued2016
dc.identifier.citationDyer SM, Crotty M, Fairhall N, et al. A critical review of the long-term disability outcomes following hip fracture. BMC Geriatrics. 2016;16(1):158. doi:10.1186/s12877-016-0332-0.en
dc.identifier.issn1471-2318
dc.identifier.urihttp://hdl.handle.net/2328/36465
dc.descriptionOpen Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en
dc.description.abstractBackground: Hip fractures are an increasingly common consequence of falls in older people that are associated with a high risk of death and reduced function. This review aims to quantify the impact of hip fracture on older people’s abilities and quality of life over the long term. Methods: Studies were identified through PubMed and Scopus searches and contact with experts. Cohort studies of hip fracture patients reporting outcomes 3 months post-fracture or longer were included for review. Outcomes of mobility, participation in domestic and community activities, health, accommodation or quality of life were categorised according to the World Health Organization’s International Classification of Functioning and synthesised narratively. Risk of bias was assessed according to four items from the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Results: Thirty-eight studies from 42 publications were included for review. Most followed a clearly defined sample from the time of fracture. Hip fracture survivors experienced significantly worse mobility, independence in function, health, quality of life and higher rates of institutionalisation than age matched controls. The bulk of recovery of walking ability and activities for daily living occurred within 6 months after fracture. Between 40 and 60 % of study participants recovered their pre-fracture level of mobility and ability to perform instrumental activities of daily living, while 40–70 % regained their level of independence for basic activities of daily living. For people independent in self-care pre-fracture, 20–60 % required assistance for various tasks 1 and 2 years after fracture. Fewer people living in residential care recovered their level of function than those living in the community. In Western nations, 10–20 % of hip fracture patients are institutionalised following fracture. Few studies reported impact on participation in domestic, community, social and civic life. Conclusions: Hip fracture has a substantial impact on older peoples’ medium- to longer-term abilities, function, quality of life and accommodation. These studies indicate the range of current outcomes rather than potential improvements with different interventional approaches. Future studies should measure impact on life participation and determine the proportion of people that regain their pre-fracture level of functioning to investigate strategies for improving these important outcomes. Keywords: Hip fracture, Recovery of function, Mobility limitation, Activities of daily living, Institutionalisation, Quality of life, Osteoporosis, Aged, Longterm care, Review Abbreviations: ADL, Activities of daily living; HR, Hazard ratio; IADL, Instrumental activities of daily living; ICF, International classification of functioning, disability and health; OR, Odds ratio; QALY, Quality adjusted life year; QOL, Quality of life; US, United States; WHO, World Health Organizationen
dc.language.isoen
dc.publisherBioMed Centralen
dc.rightsCopyright © 2016 The Author(s).en
dc.titleA critical review of the long-term disability outcomes following hip fractureen
dc.typeArticleen
dc.identifier.doihttps://doi.org/10.1186/s12877-016-0332-0en
dc.rights.holderThe Author(s).en


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