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Cognitive status following a hip fracture and its association with postoperative mortality and activities of daily living : A prospective comparative study of two prehospital emergency care procedures

Larsson, Glenn LU ; Strömberg, Ulf LU ; Rogmark, Cecilia LU and Nilsdotter, Anna LU (2019) In International Journal of Orthopaedic and Trauma Nursing
Abstract

Introduction: Early assessment of hip fracture patients’ cognitive function is important for preventing pre- and postoperative complications. The aim of this study was twofold: (1) to assess prehospital cognitive function in hip fracture patients and establish whether cognitive status differs pre- and postoperatively between prehospital fast track care (PFTC) and the traditional emergency department (ED) pathway and (2) whether preoperative cognitive function is associated with postoperative mortality and activities of daily living (ADL) ability. Methods: Three hundred and ninety one hip fracture patients were prospectively included. The Short Portable Mental Status Questionnaire (SPMSQ) was used prehospital, at the orthopaedic ward and... (More)

Introduction: Early assessment of hip fracture patients’ cognitive function is important for preventing pre- and postoperative complications. The aim of this study was twofold: (1) to assess prehospital cognitive function in hip fracture patients and establish whether cognitive status differs pre- and postoperatively between prehospital fast track care (PFTC) and the traditional emergency department (ED) pathway and (2) whether preoperative cognitive function is associated with postoperative mortality and activities of daily living (ADL) ability. Methods: Three hundred and ninety one hip fracture patients were prospectively included. The Short Portable Mental Status Questionnaire (SPMSQ) was used prehospital, at the orthopaedic ward and three days postoperatively. ADL was followed up after four months. Results: No difference in patients’ cognitive function was observed between PFTC and ED. Four-month mortality was 37% for patients with dementia, 21% for those with cognitive impairment and 10% for patients without cognitive impariment. Only 26% of patients with dementia and 47% with cognitive impairment had full ADL ability, compared with 70% of patients with intact cognitive function (p < 0.001). Conclusion: PFTC did not influence hip fracture patients’ cognitive function. Patients with prehospital cognitive impairment had a poor outcome in terms of mortality and ADL, indicating the need for special care interventions.

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author
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Contribution to journal
publication status
published
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in
International Journal of Orthopaedic and Trauma Nursing
publisher
Elsevier
external identifiers
  • scopus:85068898664
ISSN
1878-1241
DOI
10.1016/j.ijotn.2019.07.001
language
English
LU publication?
yes
id
c6091589-0f20-40c0-a0a8-74c32080f746
date added to LUP
2019-07-24 11:16:46
date last changed
2019-08-28 04:57:16
@article{c6091589-0f20-40c0-a0a8-74c32080f746,
  abstract     = {<p>Introduction: Early assessment of hip fracture patients’ cognitive function is important for preventing pre- and postoperative complications. The aim of this study was twofold: (1) to assess prehospital cognitive function in hip fracture patients and establish whether cognitive status differs pre- and postoperatively between prehospital fast track care (PFTC) and the traditional emergency department (ED) pathway and (2) whether preoperative cognitive function is associated with postoperative mortality and activities of daily living (ADL) ability. Methods: Three hundred and ninety one hip fracture patients were prospectively included. The Short Portable Mental Status Questionnaire (SPMSQ) was used prehospital, at the orthopaedic ward and three days postoperatively. ADL was followed up after four months. Results: No difference in patients’ cognitive function was observed between PFTC and ED. Four-month mortality was 37% for patients with dementia, 21% for those with cognitive impairment and 10% for patients without cognitive impariment. Only 26% of patients with dementia and 47% with cognitive impairment had full ADL ability, compared with 70% of patients with intact cognitive function (p &lt; 0.001). Conclusion: PFTC did not influence hip fracture patients’ cognitive function. Patients with prehospital cognitive impairment had a poor outcome in terms of mortality and ADL, indicating the need for special care interventions.</p>},
  author       = {Larsson, Glenn and Strömberg, Ulf and Rogmark, Cecilia and Nilsdotter, Anna},
  issn         = {1878-1241},
  language     = {eng},
  month        = {07},
  publisher    = {Elsevier},
  series       = {International Journal of Orthopaedic and Trauma Nursing},
  title        = {Cognitive status following a hip fracture and its association with postoperative mortality and activities of daily living : A prospective comparative study of two prehospital emergency care procedures},
  url          = {http://dx.doi.org/10.1016/j.ijotn.2019.07.001},
  year         = {2019},
}