Comparison of motor importance scale functional independence and Barthel index to predict mortality after hip fractures in the elderly population

• Published in: Medicinski podmladak Vol. 68; no. 1; pp. 21 - 25
• Main Authors: Aleksic, Milica, Dubljanin-Raspopovic, Emilija
• Format: Journal Article
• Language: English
• Published: University of Belgrade, Medical Faculty 2017
• Subjects: Barthel; FIM; hip fracture
• ISSN: 0369-1527; 2466-5525
• DOI: 10.5937/mp68-13461

Introduction: Hip fractures represent an important medical, social, and economical problem of modern age. Between 14% and 36% of people with hip fracture die in the first year after the fracture. The largest number of survivors fail to regain the pre-injury walking ability and level of activity. High rates of mortality and morbidity point out the necessity of identifying and defining the determinants of outcome, which could potentially be influenced on with the aim to reduce mortality, and disability, as are result of this event. The aim: To determine whether two different scales to measure functional disability are equally sensitive predictors of mortality in elderly patients with hip fracture. Materials and Methods: The study included 299 patients older than 65 years that were operatively treated at the Institute for Orthopaedic Surgery and Traumatology for a period of one year, due to acute hip fracture. Preoperatively, patients were questioned regarding socio-demographic variables, cognitive status, functional disability before the accident, type of hip fracture and operational risk. Functional disability before the accident was measured using the motor subscale of the functional test of independence (motor FIM) and Barthel index. In order to examine the association between different preoperative variables and intrahospital/one-year mortality as starting variables, multivariate logistic regression analysis were performed, in which the influence of motor FIM and the Barthel index were examined separately. Results: The study confirmed that patients who had a higher level of functional disability before fracture, have a higher risk of short-term and long-term mortality after hip fracture. The most important result of this work is that Barthel's index and motor FIM test are equally effective predictors of short-term and long-term mortality. Conclusion: Our study revealed the importance of functional impairment prior to injury, for the prediction of mortality after hip fracture. Because of its simplicity the Barthel index should be the test of choice for the evaluation of pre-injury functional disability in patients with hip fractures.