Postoperative Physical Therapy to Prevent Hospital-acquired Pneumonia in Patients Over 80 Years Undergoing Hip Fracture Surgery—A Quasi-experimental Study

Figures & data

Table 1 Demographic Data of Included Patients Undergoing Hip Fracture Surgery

	Physical Therapy Group (n=69)	Control Group (n=64)	p-value
Gender: female	57 (83%)	47 (73%)	0.201
Age, years, mean (range)	88±5 (80–101)	89±5 (80–97)	0.360
Dementia	17 (25%)	26 (41%)	0.049
Multimorbidity	44 (64%)	44 (69%)	0.501
Living situation:			0.033
Own residence	56 (81%)	40 (63%)
Short-term residence	0	2 (3%)
Assisted living	13 (19%)	22 (34%)
Mobilization ability			0.932
Without assistive devices	20 (29%)	17 (27%)
Crutch/cane	4 (6%)	3 (5%)
Rollator/walker	42 (61%)	39 (61%)
Wheelchair	2 (3%)	3 (5%)
Mostly bedridden	1 (1%)	2 (3%)

Notes: Data are presented as number (%) or mean ±SD unless otherwise stated. Statistical significance p<0.05.

Table 2 Hip Fracture Types and Surgical Procedures

	Physical Therapy Group (n=69)	Control Group (n=64)	p-value
Fracture type: Fracture of head and neck of femur, intended (code S72.0)	24 (35%)	29 (45%)	0.316
Pertrochanteric fracture (code S72.1)	34 (49%)	30 (47%)
Subtrochanteric fracture (code S72.2)	9 (13%)	3 (5%)
Other type of hip fracture	2 (3%)	2 (3%)
Cause of fracture:			0.524
Fell out of bed	1 (1%)	3 (5%)
Tripped/fell	59 (86%)	55 (86%)
Missed the chair, fell out of the chair	4 (6%)	4 (6%)
Other	5 (7%)	2 (3%)
Site of accident:			0.488
At home, indoors	54 (78%)	55 (86%)
Away from home, indoors	4 (6%)	3 (5%)
Outdoors	11 (16%)	6 (9%)
Delay prior to surgery:			0.450
0–24 hours	50 (72%)	50 (78%)
≥25 hours	19 (28%)	14 (22%)
Type of surgery:			0.082
Prosthesis, total/partial	27 (39%)	16 (25%)
Osteosynthesis	42 (61%)	48 (75%)
Duration of surgery, minutes (range)	51±3 (11–158)	39±3 (8–123)	0.011
Postoperative blood transfusion	32 (46%)	36 (56%)	0.255
Postoperative confusion	23 (33%)	42 (66%)	0.000

Notes: Data are presented as number (%) or mean ±SD unless otherwise stated. Statistical significance p<0.05.

Table 3 Data on Discharge from Hospital

	Physical Therapy Group (n=69)	Control Group (n=64)
Number of hospital days Hospital days after completed medical treatment:^a	10±4	13±9
0–5	8 (12%)	0 (0%)
6–11	31 (45%)	32 (50%)
≥ 12	2 (3%)	5 (8%)
NA^b	28 (40%)	27 (42%)
Discharged to:
Home	26 (38%)	25 (39%)
Short-term residence	23 (33%)	17 (27%)
Another ward	9 (13%)	2 (3%)
Assisted living	11 (16%)	18 (28%)
Deceased	0 (0%)	2 (3%)
Walking aid at discharge:
Without assistive devices	0 (0%)	0 (0%)
Rollator	27 (39%)	28 (44%)
Walker	34 (49%)	19 (30%)
Wheelchair	4 (6%)	11 (17%)
Bedridden	4 (6%)	4 (6%)
Not stated	0 (0%)	2 (3%)

Notes: Data are presented as mean ±SD or number (%). Statistical significance p<0.05. ^aNumber of days from the time that the patient completed medical treatment until hospital discharge. Includes waiting for a care management plan and then waiting for hospital discharge. ^bPatient returns to previous type of housing without municipal interventions, with no change in municipal interventions, or is transferred to a different hospital ward.

Table 4 Mobilization Activity in the Physical Therapy Group (n=69), According to the Cumulated Ambulation Score (CAS) Tool, at Inclusion and Discharge

CAS	At Inclusion (n=69)	At Discharge (n=69)
0	7 (10%)	0 (0%)
1	19 (28%)	2 (3%)
2	22 (32%)	8 (12%)
3	20 (29%)	41 (59%)
4	0 (0%)	5 (7%)
5	0 (0%)	5 (7%)
6	1 (1%)	8 (12%)

Notes: Three activities were included: (a) rise from lying in bed to sitting at the edge of the bed and back to lying; (b) sitting to standing to sitting in a chair with armrests; and (c) walking at least 3 m. Each activity was assessed on a scale from 0 to 2, where 0=incapable of performing the activity, despite human assistance and verbal instructions; 1=can perform the activity, assisted by one or more people and/or with verbal instructions; 2=can perform the activity, safely and without verbal instructions or human assistance or supervision. The total score is 0–6: the higher the score, the more independent the patient.