Advanced prediction of functional outcomes in hip fracture patients using premorbid functional assessments

This historical cohort study aims to determine the relationship between premorbid functional status and functional decline in hip fracture patients. Eighty-two hip fracture patients were divided into Group A (good rehabilitation potential) and Group B (fair rehabilitation potential) based on four premorbid functional assessments: Modified Functional Ambulation Category (MFAC), Modified Barthel Index (MBI), Hong Kong Montreal Cognitive Assessment 5-Minute and functional prognosis predictive score. Declines in MFAC and MBI after rehabilitation were compared. Sixty-seven percent of patients in Group A had up to one category decline in final MFAC, whereas 66% in Group B had more than one category decline. Similarly, median decline in final MBI was seven in Group A versus 22 in Group B. Hip fracture patients with good rehabilitation potential have significantly fewer functional declines. It is possible for them to be directly discharged from acute hospital for outpatient rehabilitation. 此歷史隊列研究，旨在確立髖部骨折患者的病前功能狀態與功能衰退之間的關係。 八十二名髖部骨折患者，基於四項病前功能評估，包括功能性步行分級量表改良版（MFAC）、巴氏量表改良版（MBI）、香港版蒙特利爾認知評估五分鐘版和功能性預後預測評分，被分為A組（良好復康潛力）和B組（一般復康潛力），以比較復康後MFAC和MBI之下降情況。 67％的A組患者之最終MFAC最多下降了一級，而B組卻有66％下降了超過一級 。同樣地，A組之最終MBI的中位數下降了7，而B組卻是22。 具有良好復康潛力的髖部骨折患者，功能衰退明顯地減少。他們有條件直接從急症醫院出院，以接受門診復康治療。