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

Aicha Goubar, kings london, Lauren Beaupre, Ian D Cameron, kings london, Celia L Gregson, Antony Johansen, Morten Tange Kristensen, Jay Magaziner, kings london, Catherine M Sackley, Euan Sadler, Toby O Smith, Boris Sobolev, kings london*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Abstract

Purpose
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 5,395 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 hours, ≥2 hours; 30-minute 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 hours versus < 2 hours physiotherapy, and 1.11 (95% CI 1.08-1.15) and 1.10 (95% CI 1.05-1.15) for an additional 30-minutes 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 seven-day physiotherapy service totalling at least two hours in the first postoperative week may be considered a key performance indicator of acute care quality after hip fracture.
Original languageEnglish
Number of pages108
JournalOsteoporosis International
Early online date8 Nov 2021
DOIs
Publication statusE-pub ahead of print - 8 Nov 2021

Keywords

  • rehabilitation
  • neck of femur
  • recovery
  • hip fracture
  • audit
  • National Hip Fracture Database

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