Atrial fibrillation is not associated with rehabilitation outcomes of elderly hip fracture patients

作者：Adunsky Abraham^*; Arad Marina; Koren Morag Nira; Fleissig Yudit; Mizrahi Eliyahu Haim

来源：Geriatrics and Gerontology International, 2012, 12(4): 688-694.

DOI：10.1111/j.1447-0594.2012.00845.x

• atrial fibrillation
• hip fracture
• orthogeriatric
• outcome

Aim: To study possible differences in rehabilitation outcomes of patients with hip fracture, with and without atrial fibrillation.
Methods: A retrospective cohort study comprising 1114 patients, divided into three groups: patients with sinus rhythm, paroxysmal atrial fibrillation or chronic atrial fibrillation. All patients underwent a standard orthogeriatric care comprising surgical hip repair and a rehabilitation course. Main outcome measures included functional status at discharge by the Functional Independence Measure, post-fracture functional status category and type of postdischarge living arrangement.
Results: Patients with atrial fibrillation differed from patients in sinus rhythm by female sex (P = 0.018), older age (P = 0.008) and higher rates of heart failure (P < 0.001), ischemic heart disease (P < 0.001), previous stroke (P < 0.001), and American Society of Anesthesiologists score (P < 0.001). No differences were observed among the three groups regarding Functional Independence Measure motor and total scores. In regression analysis, Mini-Mental State Examination (P < 0.001), prefracture status (P < 0.001), postsurgery motor Functional Independence Measure (P < 0.0001) and Parkinson's disease (P = 0.009) were predictive of higher motor Functional Independence Measure at discharge, whereas atrial fibrillation had no predictive value whatsoever. There were no differences among groups in magnitude of postfracture change of functional status category or type of postdischarge living arrangement.
Conclusions: Discharge motor Functional Independence Measure scores, postfracture changes in functional status and in discharge placement are similar in hip fracture patients with sinus rhythm, compared with those with atrial fibrillation. Atrial fibrillation should not be considered to adversely affect the rehabilitation outcome of these patients. Geriatr Gerontol Int 2012; 12: 688-694.

• 出版日期2012-10