With simple technology investigators can map how long it takes for a patient with a hip fracture to be helped and encouraged to stand and walk in the days following the injury. A small sensor on the thigh can measure advanced data regarding movement patterns. The limited research results available show that patients spend too much time lying down or sitting, which can lead to poorer recovery, complications, and an increased risk of death. The project maps the current situation in orthopedic emergency care as well as in orthopedic geriatric care, which is provided in a modern building with single rooms and private bathrooms. In addition to better understanding the significance of different care models, the project aims to present baseline data that future intervention studies can use as control material. The project will also connect the activity level of the patients during the hospital stay with ongoing rehabilitation studies in community follow-up care.
Purpose and Specific Objectives Can better diagnosis and prevention of inactivity after hip fractures improve outcomes for individuals and society? The goal is to measure how much individuals with hip fractures move during their hospital stay, to investigate the link between activity levels and complications such as thromboembolism, infections, and mortality, and to use inertial measurement units (IMU) to provide feedback to patients and healthcare providers. Outcomes after frailty-related fractures remain poor, despite improved orthopedic surgical treatment. Every year, at least 50,000 people over the age of 65 in Sweden sustain a major fracture. Despite enhanced treatment and care, a fracture in older individuals often leads to permanent reductions in function and quality of life. Hip fractures are also associated with an increased risk of death. In addition to personal consequences, the many fractures have significant effects on healthcare and social elder care. Relatives are also affected. Falls are estimated to cost society over 14 billion kronor annually. To improve recovery and avoid complications after a fracture, coworkers must think broadly and innovatively in healthcare. Given the rapid changes in lifestyle and socioeconomics, it is questionable whether healthcare providers can apply research findings based on previous generations to today's older adults, for example concerning physical activity. A hip fracture is surgically treated so that the skeleton can withstand immediate weightbearing. However, patients spend too much time immobilized, according to the limited research available. This inactivity can lead to limited recovery, complications such as infections and thromboembolism, longer hospital stays, and an increased risk of death.
Study Type
OBSERVATIONAL
Enrollment
40
A sensor, an inertial measurement unit (IMU), will be attached to the thigh when the individual is on the postoperative ward and will be worn throughout the hospital stay. The IMU measures 7.9 x 3.2 x 0.8 cm and records body positions, movements, and gait parameters.
Dept. of Orthopaedics, Skane University Hospital
Malmo, Sweden
Minutes in upright position per day
Sitting, standing or walking as measured by the IMU
Time frame: During hospital stay, an average of one week
Complications within 30 days
Mortality and Incidence of infection or venous thromboembolism within 30 days
Time frame: 30 days from surgery
Association with type of fracture
Association between total time in upright position with type of fracture (intra- or extracapsular)
Time frame: During hospital stay, an average of one week
Association with type of surgical method
Association between total time in upright position with type of surgical method (hemiarthroplasty, total hip arthroplasty, internal fixation)
Time frame: During hospital stay, an average of one week
Association with duration of surgery
Association between total time in upright position with duration of surgery (min)
Time frame: During hospital stay, an average of one week
Association with age
Association between total time in upright position with age (years)
Time frame: During hospital stay, an average of one week
Association with sex
Association between total time in upright position with sex (male/female)
Time frame: During hospital stay, an average of one week
Association with comorbidities (ASA grade)
Association between total time in upright position with comorbidities measured by ASA grade (American society of anesthesiologists classification system)
Time frame: During hospital stay, an average of one week
Association with frailty (CFS)
Association between total time in upright position with frailty (CFS - Clinical Frailty Score)
Time frame: During hospital stay, an average of one week
Association with presence of dementia
Association between total time in upright position with presence of dementia (medical record information on ICD-code for dementia disease)
Time frame: During hospital stay, an average of one week
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