Prefracture functional level evaluated by the New Mobility Score predicts in-hospital outcome after hip fracture surgery

Figures & data

Breakdown of 437 consecutive patients with hip fracture, 280 of whom were finally included in the analyses of independence in basic mobility and residential status on discharge.

Table 1.  Distribution of outcome measures according to predictor variables and length of stay (LOS), n = 280

Predictor variables	All patients n = 280	In-hospital independency in basic mobility (CAS = 6)		Discharge to own home
		Yes n = 223 (80)	No n = 57 (20)	Yes n = 218 (78)	No n = 62 (22)
Age (years)	81 (72–86)	80 (70–85)	84 (81–91)	80 (69)	84 (81–90)
P-value		< 0.001 ^a		< 0.001 ^a
Female	203 (73)	161 (79)	42 (21)	156 (77)	47 (23)
Male	77 (27)	62 (80)	15 (20)	62 (81)	15 (19)
P-value		0.8 ^b		0.5 ^b
Prefracture function
Low, NMS (0–6)	132 (47)	79 (60)	53 (40)	76 (58)	56 (42)
High, NMS (7–9)	148 (53)	144 (97)	4 (3)	142 (96)	6 (4)
P-value		< 0.001 ^c		< 0.001 ^c
Low mental status	44 (16)	25 (57)	19 (43)	25 (57)	19 (43)
High mental status	236 (84)	198 (84)	38 (16)	193 (82)	43 (18)
P-value		< 0.001 ^b		< 0.001 ^b
Health status
Good (ASA score 1-2)	145 (52)	126 (87)	19 (13)	121 (83)	24 (17)
Poor (ASA score 3-4)	135 (48)	97 (72)	38 (28)	97 (72)	38 (28)
P-value		0.002 ^b		0.02 ^b
Fracture type
Cervical	148 (53)	132 (89)	16 (11)	125 (85)	23 (15)
Intertrochanteric d	132 (47)	91 (69)	41 (31)	93 (71)	39 (29)
P-value		< 0.001 ^b		0.005 ^b
LOS	13 (8-21)	11 (8–16)	24 (15–33)	11 (7–16)	24 (17–36)
P-value		< 0.001 ^a		< 0.001 ^a

Values are presented as median (25–75% quartiles) as number of patients (%), or as correlations.

a Mann-Whitney,

b Chi-square,

c Fischer's Exact test. d 7 patients with subtrochanteric fractures included.

CAS; Cumulated Ambulation Score, NMS; New Mobility Score,

ASA; American Society of Anaesthesiologists rating

Table 2.  Simple and multiple logistic regression analysis of patients with hip fracture not regaining independency in basic mobility (CAS < 6), during admittance, n = 280

Predictor variables	Crude OR		Adjusted OR
	(95% CI)	P-value	(95% CI)	P-value
Age (continuous)	1.090 (1.048–1.132)	< 0.001	1.046 (1.001–1.093)	0.04
Female sex	1 (0.6–2.1)	0.8	0.2 (0.2–1.3)	0.2
Low prefracture functional
level (NMS 0–6)	24 (8–69)	< 0.001	18 (6–55)	< 0.001
Low mental status	4.0 (2–8)	< 0.001	2.0 (0.8–4.5)	0.1
Poor health status (ASA 3–4)	2.0 (1.1–3.6)	0.02	1.5 (0.7–3.3)	0.3
Intertrochanteric fracture	2.3 (1.3–4.1)	0.005	4.2 (2–9)	< 0.001

OR; odds ratio, CI; confidence interval. Other abbreviations presented in Table 1.

Table 3.  Simple and multiple linear regression analysis of time from surgery to independent mobility in days (CAS = 6) in the orthopedic ward, n = 214

Predictor variables	Crude B-values		Adjusted B-values
	(95% CI)	P-value	(95% CI)	P-value
Age (continuous)	0.1 (0.1–0.2)	< 0.001	0.1 (0.06–0.13)	< 0.001
Female sex	1.5 (0.5–2.6)	0.005	0.03 (–0.9–1.0)	1
Low prefracture functional
Level (NMS 0–6)	3.4 (2.5–4.3)	< 0.001	2.7 (1.8–3.6)	< 0.001
Low mental status	1.0 (-0.5–2.6)	0.2	0.3 (–0.9–1.5)	0.6
Poor health status (ASA 3–4)	1.0 (1.2–3.1)	0.04	0.3 (–0.5–1.1)	0.5
Intertrochanteric fracture	2.1 (1.2–3.1)	< 0.001	2.3 (1.5–3.1)	< 0.001
Constant	–	–	-9.1 (–12.2–6)	< 0.001

CI; confidence interval. Other abbreviations presented in Table 1.

Table 4.  Simple and multiple logistic regression analysis of patients not being discharged directly to their own home from the orthopedic ward, n = 280

Predictor variables	Crude OR		Adjusted OR
	(95% CI)	P-value	(95% CI)	P-value
Age (continuous)	1.097 (1.055–1.140)	< 0.001	1.056 (1.013–1.102)	0.010
Female sex	1.2 (0.6–2.4)	0.5	0.5 (0.2–1.3)	0.2
Low prefracture functional
Level (NMS 0–6)	18 (7–43)	< 0.001	13 (5–33)	< 0.001
Low mental status	3.3 (1.7–6.7)	< 0.001	1.6 (0.7–3.6)	0.3
Poor health status (ASA 3–4)	2.0 (1.1–3.6)	0.02	1.1 (0.5–2.2)	0.9
Intertrochanteric fracture	2.3 (1.3–4.1)	0.005	2.2 (1.1–4.4)	0.02

OR; odds ratio, CI; confidence interval. Other abbreviations presented in Table 1