Abstract

Abstract

Summary

Additional physiotherapy in the first postoperative week was associated with fewer days to discharge after hip fracture surgery. A 7-day physiotherapy service in the first postoperative week should be considered as a new key performance indicator in evaluating the quality of care for patients admitted with a hip fracture.

Introduction

To examine the association between physiotherapy in the first week after hip fracture surgery and discharge from acute hospital.

Methods

We linked data from the UK Physiotherapy Hip Fracture Sprint Audit to hospital records for 5395 patients with hip fracture in May and June 2017. We estimated the association between the number of days patients received physiotherapy in the first postoperative week; its overall duration (< 2 h, ≥ 2 h; 30-min increment) and type (mobilisation alone, mobilisation and exercise) and the cumulative probability of discharge from acute hospital over 30 days, using proportional odds regression adjusted for confounders and the competing risk of death.

Results

The crude and adjusted odds ratios of discharge were 1.24 (95% CI 1.19–1.30) and 1.26 (95% CI 1.19–1.33) for an additional day of physiotherapy, 1.34 (95% CI 1.18–1.52) and 1.33 (95% CI 1.12–1.57) for ≥ 2 versus < 2 h physiotherapy, and 1.11 (95% CI 1.08–1.15) and 1.10 (95% CI 1.05–1.15) for an additional 30-min of physiotherapy. Physiotherapy type was not associated with discharge.

Conclusion

We report an association between physiotherapy and discharge after hip fracture. An average UK hospital admitting 375 patients annually may save 456 bed-days if current provision increased so all patients with hip fracture received physiotherapy on 6–7 days in the first postoperative week. A 7-day physiotherapy service totalling at least 2 h in the first postoperative week may be considered a key performance indicator of acute care quality after hip fracture.

Details

Title
The impact of the frequency, duration and type of physiotherapy on discharge after hip fracture surgery: a secondary analysis of UK national linked audit data
Author
Goubar, A 1 ; Ayis, S 1 ; Beaupre, L 2 ; Cameron, I D 3 ; Milton-Cole, R 1 ; Gregson, C L 4 ; Johansen, A 5 ; Kristensen, M T 6 ; Magaziner, J 7 ; Martin, F C 1 ; Sackley, C 8 ; Sadler, E 9 ; Smith, T O 10 ; Sobolev, B 11 ; Sheehan, K J 1   VIAFID ORCID Logo 

1  King’s College London, Department of Population Health Sciences, School of Population and Environmental Sciences, London, UK (GRID:grid.13097.3c) (ISNI:0000 0001 2322 6764) 
2  University of Alberta, Department of Physical Therapy, Faculty of Rehabilitation Medicine, Edmonton, Canada (GRID:grid.17089.37) (ISNI:0000 0001 2190 316X) 
3  University of Sydney, John Walsh Centre for Rehabilitation Research, Kolling Institute, Northern Sydney Local Health District and Faculty of Medicine and Health, Sydney, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X) 
4  University of Bristol, Musculoskeletal Research Unit, Translation Health Sciences, Bristol Medical School, Bristol, UK (GRID:grid.5337.2) (ISNI:0000 0004 1936 7603) 
5  University Hospital of Wales, Cardiff Trauma Unit, Cardiff, UK (GRID:grid.241103.5) (ISNI:0000 0001 0169 7725) 
6  University of Copenhagen, Department of Physical & Occupational Therapy, Copenhagen University Hospital – Bispebjerg and Frederiksberg, and Department of Clinical Medicine, Copenhagen, Denmark (GRID:grid.5254.6) (ISNI:0000 0001 0674 042X) 
7  University of Maryland School of Medicine, Department of Epidemiology and Public Health, Baltimore, USA (GRID:grid.411024.2) (ISNI:0000 0001 2175 4264) 
8  King’s College London, Department of Population Health Sciences, School of Population and Environmental Sciences, London, UK (GRID:grid.13097.3c) (ISNI:0000 0001 2322 6764); University of Nottingham, Faculty of Medicine, Nottingham, UK (GRID:grid.4563.4) (ISNI:0000 0004 1936 8868) 
9  University of Southampton, Faculty of Environmental and Life Sciences, School of Health Sciences, Southampton, UK (GRID:grid.5491.9) (ISNI:0000 0004 1936 9297) 
10  University of East Anglia, Faculty of Medicine and Health Sciences, Norwich, UK (GRID:grid.8273.e) (ISNI:0000 0001 1092 7967) 
11  University of British Columbia, School of Population and Public Health, Vancouver, Canada (GRID:grid.17091.3e) (ISNI:0000 0001 2288 9830) 
Pages
839-850
Publication year
2022
Publication date
Apr 2022
Publisher
Springer Nature B.V.
ISSN
0937941X
e-ISSN
1433-2965
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1007/s00198-021-06195-9
ProQuest document ID
2640574701
Copyright
© The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.