Association between early sitting and functional mobility recovery after hip-fracture surgery in older patients: a prospective cohort study.

Abstract

Background: Hip fractures significantly impact older adults, leading to compromised mobility and various adverse outcomes. The importance of early post-surgery mobilization in regaining pre-fracture levels of mobility is recognized, but lacks standardized definitions and implementation strategies. This study aimed to assess the impact of early sitting position 24 h after hip-fracture surgery on functional mobility recovery after 30 days using data from the Spanish National Hip Fracture Registry (RNFC).

Methods: Prospective cohort study, including patients aged ≥ 75 years admitted for hip-fracture surgery between 2017 and 2020 at Sant Camil Residential Hospital. Data from the RNFC were analyzed, and linear regression models were developed to assess the association between early sitting after surgery (ESAS) and mobility recovery at 30 days after surgery.

Results: Of 486 identified patients, 321 were included, with an estimated ESAS prevalence of 38.32% (95% CI: 32.97-43.88). ESAS was significantly associated with improved mobility recovery at 30 days. Multivariate regression models consistently revealed ESAS as a modest independent predictor of better post-surgery mobility. Factors such as age, cognitive capacity, and general health also impacted mobility recovery.

Conclusion: The ESAS effect, while modest, emerges as a significant predictor of hip mobility recovery among older patients with hip fractures 30 days after surgery. These findings underscore the potential of this low-risk, low-cost intervention in enhancing functional mobility recovery strategies and emphasize the need for further research to uncover its broader implications in post-operative care. Implementation of early sitting could be enhanced, as only a third of patients in our study underwent this simple intervention.