To assess the relationship between mobility recovery after hip fracture surgery and mortality risk.
Approach:
Study Design: Nationwide cohort study analyzing data from 33,486 patients aged 65 and older who underwent surgery for first-time unilateral low-energy hip fractures between January 2016 and November 2021.
Mobility Assessment: Mobility was assessed using the Cumulated Ambulation Score, measuring independence in various mobility tasks.
Outcomes: Primary outcomes included reoperation rates within 30 days and 1 year, while secondary outcomes focused on all-cause mortality at the same time points.
Key Findings:
65% of patients did not regain prefracture mobility by discharge.
30-day mortality was 9% for those who did not regain mobility versus 3% for those who did, with failure to regain mobility associated with about twice the likelihood of mortality within 30 days.
At 1 year, mortality was 29% for patients who did not regain mobility compared to 12% for those who did.
A dose-response relationship was observed, with increased mortality correlating with greater mobility loss.
Mobility recovery was not consistently linked to reoperation risk.
Interpretation:
Limitations:
The observational nature of the study limits causal inferences.
Factors such as frailty, comorbidity, and postoperative complications may confound the relationship between mobility and mortality.
Decisions regarding reoperation may be influenced by competing mortality risks and treatment preferences.
