01 | Life-space mobility one year after hip fracture surgery in non-institutionalized older patients

Elena Bogliacino¹, Fiammetta Monacelli², Monica Pizzonia³, Alberto Cella¹ | ¹S.C. Assistenza e Residenzialità Anziani, Azienda Tutela Salute Liguria - Area 2 Savona; ²Professore Associato in Geriatria, Università agli Studi di Genova; ³S.S. Ortogeriatria, Clinica Geriatrica, Ospedale Policlinico San Martino di Genova.

Introduction. Life-space mobility (LSM) refers to the spatial extent of a person's movements within their environment (from their bedroom to outside their town), encompassing where they go, how frequently, and the level of assistance required. While it is known that functional recovery one year after hip fracture surgery is often incomplete, it is still unclear to what extent this kind of fracture affects LSM.

Objectives. Our study aims to evaluate the level of LSM 1-year after hip fracture surgery in non-institutionalized older patients (pts).
Materials and Methods. 131 consecutive pts scheduled for surgery for proximal femoral fracture underwent a comprehensive geriatric assessment. The following data were also recorded: length of stay, surgical complications, delirium, pressure ulcers, anemia requiring transfusions, time to stand and walk. One year after surgery we evaluated: living arrangement (home/residential facility), readmissions, falls, fractures, and LSM assessed by means of the University of Alabama at Birmingham (UAB) Life Space Assessment (LSA) scale.

Results. Mean age of the sample: 86.6 years (±5.74), female: 88.6%; 6 pts died during hospital stay. After one year, 31 patients had died, 10 were living in a residential facility, and 22 had been lost to follow-up for different reasons. The LSA values of the remaining 61 pts ​​were low overall (median 28, IQR 0.28); we divided them into tertiles to investigate which factors could explain the higher level of LSM. After testing the data in univariate analysis, we examined several binomial logistic regression models and found that the best predictive combination of upper tertile of LSA included age (Odds Ratio 1.37, p=0.01), female sex (OR 0.025, p=0.017), and pre-fracture Barthel score (OR 0.87, p<0.001); precision 0.85, specificity 0.92, sensibility 0.71, Area Under the Curve (AUC) 0.92.

Conclusions. One year after a hip fracture LSM is on average low, more due to the pre-existing frailty profile than to the outcome following orthopedic surgery.