Frailty and functional decline after hip fracture surgery

Frailty is a multifactorial clinical syndrome which is related to adverse health outcomes, hospitalization and mortality. In this study we aim to find the best way of assessing frailty in patients with hip fracture, eligible for surgery. Furthermore we will describe the relation between frailty, functional status and other patient characteristics and adverse outcomes as functional decline, length of stay, admissions and mortality.
Negative outcomes are seen in patients after surgery for a hip fracture. Involvement of a geriatric team is expected to improve health outcomes.

We think involvement of a geriatric team decreases readmissions, length of stay and mortality.

The aim of the study is to explore the relation between frailty, functional status and other patient characteristics and adverse outcomes as functional decline, length of stay, admissions and mortality. Frailty is multifactorial and is known to be related to adverse health outcomes, hospitalization and mortality. The degree of frailty depends on the instruments used. The Groninger Frailty Indicator (GFI) is expected to have more predicitive value than other frailty indicators. Involvement of a geriatric team is thought to improve outcomes. Defined as less functional decline.

-Pre-operative: Barthel questionnaire, GFI, Hand grip dynamometry, ISAR-HP

-During stay at the hospital: delirium screening

-Day of discharge hospital: Hand grip dynamometry, MMSE

-Day of discharge nursing home: Barthel, time to successful rehabilitation

-Post-operatively 2 months (out-patient department): Barthel questionnaire, GFI, Hand grip dynamometry

-Post-operatively 6 and 12 months (questionnaire by telephone): number of fall incidents, Barthel questionnaire

-Post-operatively 12 months: mortality and re-admissions.

-Hand grip dynamometry