Outcomes and Impact of Fragility Fracture among Geriatrics Patients who Underwent Hip Surgery in Hospital Kuala Lumpur

Abstract

INTRODUCTION: Fragility fractures are common in the elderly. It is associated with increased mortality, reduced mobility, and poorer quality of life. In addition, post-operative functional outcomes are limited locally. MATERIALS AND METHODS: A cross-sectional phone interview was conducted with elderly patients who underwent hip surgery or their caregivers between March 2019 and Feb 2020, at least six months after the operation. RESULTS: A total of 137 cases were approached, and 77 subjects completed the interview (58.4%), among which 54/77 (70.1%) were female, and 66/77 (85.7%) were caregivers. The proportion of subjects who could ambulate independently dropped from 66/77, prior to fracture, to 17/77 post-surgery. We noted a significant deterioration in the modified Barthel Index from the median of 100 (IQR = 0) to 91 (IQR 25.5; p <0.001). There was also a significant decline in the self-perceived physical strength of 30% (IQR 30, p <0.001); and in the functionality of 35% (IQR40; p <0.001). A total of 48/77 (62.3%) returned to their original residence, while 5 cases (6.5%) were institutionalised, and 14/77 (18.2%) died prior to the survey. Thirty-six subjects reported additional costs in the care of patients, ranging from RM100 to RM6000 (USD25 to USD1450) per month. CONCLUSION: Decline in physical and functional status is closely related to the quality of life as the majority reported a poorer health status after the fracture. Although this study is limited by the small sample size, it provided insights into patients' experiences and household burdens. Hence, well- coordinated services and monitoring are important for better outcomes.

Keywords

• fragility fracture
• hip surgery
• orthogeriatric
• functional outcome
• economic burden