医療法人社団岡田会

Aim/Objective:In rehabilitation care after surgery for hip fractures,we examined the efficiency of the

comprehensive Functional Independence Measure(FIM) and factors that affect home discharge.

Methods:Patients who were hospitalized and discharged for rehabilitation medicine of hip fractures between August 2020 and August 2025 included. However,we excluded(1) cases of death during hospitalization,(2)cases of hospitalization period of less than 4 weeks,(3)cases of conservative treatment of hip fractures and(4) patients who did not live at home before hospitalization.

Results:102 patients were included. A total of 81 patients(79.4%)were discharged home. There were 16 males(15.7%) with an average age of 84.3±7.7 years. At admission, the average FIM(motor items) was 34.7±14.4,the average  FIM (cognitive items) was 21.6±8.6,and the average total FIM was 56.3±20.2. At discharge,the average FIM (motor items) was 68.0±23.1, the average FIM(cognitive items) was 24.5±8.7, and the average comprehensive FIM was 92.5±30.5. The mean time from hip fracture to surgery was 6.7±14.1 days. The mean value of Hasegawa's Dementia Scale-Revised(HDS-R) was 17.9±7.8. HDS-R(HDS-R(P value <0.0001) was independent factor that contributed to overall FIM efficiency in multivariate analysis. independent factor that contributed to home discharge in multivaluate analysis was Clinical Frailty Scale (P value 0.0448, odds ratio 0.42 ,95% Cl(0.15-0.98) Area Under the Curve (AUC)0.77 Cut off value 5)

Conclusion:It was thought that cognitive function was primarily related to whether rehabilitation care after surgery for hip fractures would improve the patient`s condition effeciently. The degree of frailty at the time of admission appears to be related to home discharge of rehabilitation care after surgery for hip fractures.