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Effect of Preexisting Cognitive Impairment on In-Patient Treatment and Discharge Management among Elderly Patients with Hip Fractures

Title: Effect of Preexisting Cognitive Impairment on In-Patient Treatment and Discharge Management among Elderly Patients with Hip Fractures
Authors: Bliemel, Christopher; Lechler, Philipp; Oberkircher, Ludwig; Colcuc, Christian; Balzer-Geldsetzer, Monika; Dodel, Richard; Ruchholtz, Steffen; Buecking, Benjamin
Source: Dementia and Geriatric Cognitive Disorders ; volume 40, issue 1-2, page 33-43 ; ISSN 1420-8008 1421-9824
Publisher Information: S. Karger AG
Publication Year: 2015
Description: Objective: To examine the influence of cognitive impairment on the functional outcomes and complication rates of patients with hip fracture during in-patient treatment. Methods: A total of 402 patients who were surgically treated for hip fractures were consecutively enrolled at a single trauma center. The patients were grouped according to their results on the Mini-Mental State Examination (MMSE), i.e., ≥20 points (group I) and ≤19 points (group II). Complication and in-hospital mortality rates as well as postoperative functional outcomes according to the Barthel Index (BI) were compared between the groups. A multivariate regression analysis was performed to control for additional factors. Results: 33% of the patients had MMSE scores ≤19 points. The complication rates were similar between the groups (p > 0.05). Likewise, the overall in-hospital mortality rates were similar between the patients in group I (4.5%) and those in group II (9.8%; β = 0.218, p < 0.740). Functional outcomes, as assessed by the BI, were lower in group II (β = -0.266, p < 0.001). The patients in group II were transferred to a rehabilitation clinic less frequently (52.3 vs. 76.0%, p < 0.001). Conclusions: Patients with lower MMSE scores are at a higher risk for poorer functional outcomes. Perioperative care should focus on the preservation of functional abilities to protect these patients from an additional loss of independence and disadvantageous clinical course.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1159/000381334
Availability: https://doi.org/10.1159/000381334; https://www.karger.com/Article/Pdf/381334
Rights: https://www.karger.com/Services/SiteLicenses ; https://www.karger.com/Services/SiteLicenses
Accession Number: edsbas.41510EE4
Database: BASE