ABSTRACT
Introduction: Fragility fractures are common in the elderly. It is associated with increased mortality, reduced mobility, and poorer quality of life. In addition, post-operative functional outcomes are limited locally. Materials and methods: A cross-sectional phone interview was conducted with elderly patients who underwent hip surgery or their caregivers between March 2019 and Feb 2020, at least six months after the operation. Results: A total of 137 cases were approached, and 77 subjects completed the interview (58.4%), among which 54/77 (70.1%) were female, and 66/77 (85.7%) were caregivers. The proportion of subjects who could ambulate independently dropped from 66/77, prior to fracture, to 17/77 post-surgery. We noted a significant deterioration in the modified Barthel Index from the median of 100 (IQR = 0) to 91 (IQR 25.5; p <0.001). There was also a significant decline in the self-perceived physical strength of 30% (IQR 30, p <0.001); and in the functionality of 35% (IQR40; p <0.001). A total of 48/77 (62.3%) returned to their original residence, while 5 cases (6.5%) were institutionalised, and 14/77 (18.2%) died prior to the survey. Thirty-six subjects reported additional costs in the care of patients, ranging from RM100 to RM6000 (USD25 to USD1450) per month. Conclusion: Decline in physical and functional status is closely related to the quality of life as the majority reported a poorer health status after the fracture. Although this study is limited by the small sample size, it provided insights into patients' experiences and household burdens. Hence, well-coordinated services and monitoring are important for better outcomes.
ABSTRACT
By 2050, it is predicted that six million hip fractures will occur each year of which the majority will happen in Asia. Malaysia is not spared from this predicted rise and its rate of increase will be one of the highest in this region. Much of this is driven by our unprecedented growth in the number of older people. Characteristics of individuals with hip fractures in Malaysia mirror what has been reported in other countries. They will be older multimorbid people who were already at risk of falls and fractures. Outcomes were poor with at least a quarter do not survive beyond 12 months and in those that do survive have limitation in their mobility and activities of daily living. Reviewing how these fractures are managed and incorporating new models of care, such as orthogeriatric care, could address these poor outcomes. Experts have warned of the devastating impact of hip fracture in Malaysia and that prompt action is urgently required. Despite that, there remains no national agenda to highlight the need to improve musculoskeletal health in the country.
ABSTRACT
@#By 2050, it is predicted that six million hip fractures will occur each year of which the majority will happen in Asia. Malaysia is not spared from this predicted rise and its rate of increase will be one of the highest in this region. Much of this is driven by our unprecedented growth in the number of older people. Characteristics of individuals with hip fractures in Malaysia mirror what has been reported in other countries. They will be older multimorbid people who were already at risk of falls and fractures. Outcomes were poor with at least a quarter do not survive beyond 12 months and in those that do survive have limitation in their mobility and activities of daily living. Reviewing how these fractures are managed and incorporating new models of care, such as orthogeriatric care, could address these poor outcomes. Experts have warned of the devastating impact of hip fracture in Malaysia and that prompt action is urgently required. Despite that, there remains no national agenda to highlight the need to improve musculoskeletal health in the country
