P-537: Clinical and functional differences at 30-days follow-up for nursing home and community dwelling hip fracture patients: analysis of 19,000 patients from the Spanish National Hip Fracture Registry (SNHFR)

摘要

Introduction: The aim of this study was analyze differences in clinical and functional outcomes at 30-days of follow-up between nursing home (NH) and community dwelling (CD) hip fracture (HF) patients. Methods: All patients over the 75 years or older hospitalized with a diagnosis of a fragility HF at 71 hospitals in Spain. They were classified depending their prefracture place of residence. One month after HF, patients or relatives were interviewed by telephone regarding their vital status, place of living, readmissions, reoperations and functional status. Worsening of ambulation capacity was mild or moderate/severe if the patient lost 1 or ≥ 2/5 points in Functional Ambulatory Category, respectively. Results: We included 18,262 patients, 4422 (24.2%) admitted from NH. Compared with CD patients at 30-day follow-up, NH patients had a higher mortality rate (10.6% vs 7.0%, p = 0.001), went to a Rehabilitation Unit less frequently (1.6 vs. 12.9% p = 0.001), were prescribed less anti-osteoporotic drugs (30.3% vs 46.1%, p = 0.001); hospital readmissions and reoperations were similar (2.9% vs. 2.9%, p = 0.615 and 2.2% and 2.3%, p = 0.699). They were less likely to return to their baseline gait (37.5 vs. 41.1%, p = 0.001) and more likely to have moderate/severe worsening of ambulation (44.5% vs. 28.0%, p = 0.001). Key conclusions: Compared with CD patients, HF patients admitted from NH had worse functional outcomes, higher mortality, fewer discharges to rehabilitation units and less treatment of osteoporosis at 30 days follow up.