TY - JOUR

T1 - Association between additional weekend rehabilitation and functional outcomes in patients with hip fractures

T2 - does age affect the effectiveness of weekend rehabilitation?

AU - Ogawa, Takahisa

AU - Onuma, Ryo

AU - Sagae, Hiromori

AU - Schermann, Haggai

AU - Kristensen, Morten Tange

AU - Fushimi, Kiyohide

AU - Yoshii, Toshitaka

AU - Jinno, Tetsuya

N1 - Publisher Copyright: © The Author(s), under exclusive licence to European Geriatric Medicine Society 2024..

PY - 2024

Y1 - 2024

N2 - Purpose: Rehabilitation after hip fracture surgery is crucial for improving physical function. Additional rehabilitation over the weekend or after working hours is reportedly associated with improved physical function; however, this may not apply to an aging population, including patients aged > 90 years. This study aimed to investigate the association between additional weekend rehabilitation and functional outcomes in different age groups. Methods: This study analyzed a cohort of patients aged ≥ 60 years who had hip fractures and were operated on from 2010 to 2018. Data were extracted from a nationwide multicentre database. Functional outcomes at discharge were compared between patients who underwent rehabilitation on weekdays only and those who underwent rehabilitation on both weekdays and weekends. The patient groups were selected using propensity score matching analysis. Furthermore, a subgroup-analysis was conducted on patients in their 60 s, 70 s, 80 s, and 90 s. Results: A total of 390,713 patients underwent surgery during the study period. After matching, each group comprised 129,583 pairs of patients. Patients who underwent weekend rehabilitation exhibited improved physical function in transferring, walking, and stair climbing at discharge, as compared with patients who did not (odds ratio [95% confidence interval]: 1.17 [1.15–1.19], 1.17 [1.15–1.2], and 1.06 [1.03–1.08], respectively). In subgroup analysis, except for stair climbing, the positive association between weekend rehabilitation and patient function was observed across all age groups. Conclusion: Weekend rehabilitation was significantly associated with improved physical function. Given the limited healthcare resources, high-demand activities such as stair climbing may be reserved for younger age groups to optimise rehabilitation therapy.

AB - Purpose: Rehabilitation after hip fracture surgery is crucial for improving physical function. Additional rehabilitation over the weekend or after working hours is reportedly associated with improved physical function; however, this may not apply to an aging population, including patients aged > 90 years. This study aimed to investigate the association between additional weekend rehabilitation and functional outcomes in different age groups. Methods: This study analyzed a cohort of patients aged ≥ 60 years who had hip fractures and were operated on from 2010 to 2018. Data were extracted from a nationwide multicentre database. Functional outcomes at discharge were compared between patients who underwent rehabilitation on weekdays only and those who underwent rehabilitation on both weekdays and weekends. The patient groups were selected using propensity score matching analysis. Furthermore, a subgroup-analysis was conducted on patients in their 60 s, 70 s, 80 s, and 90 s. Results: A total of 390,713 patients underwent surgery during the study period. After matching, each group comprised 129,583 pairs of patients. Patients who underwent weekend rehabilitation exhibited improved physical function in transferring, walking, and stair climbing at discharge, as compared with patients who did not (odds ratio [95% confidence interval]: 1.17 [1.15–1.19], 1.17 [1.15–1.2], and 1.06 [1.03–1.08], respectively). In subgroup analysis, except for stair climbing, the positive association between weekend rehabilitation and patient function was observed across all age groups. Conclusion: Weekend rehabilitation was significantly associated with improved physical function. Given the limited healthcare resources, high-demand activities such as stair climbing may be reserved for younger age groups to optimise rehabilitation therapy.

KW - Functional outcomes

KW - Hip fractures

KW - Propensity score matching

KW - Rehabilitation

U2 - 10.1007/s41999-024-00980-5

DO - 10.1007/s41999-024-00980-5

M3 - Journal article

C2 - 38703245

AN - SCOPUS:85191970685

JO - European Geriatric Medicine

JF - European Geriatric Medicine

SN - 1878-7649

ER -