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Early postoperative Barthel index score and long-term walking ability in patients with trochanteric fractures walking independently before injury: a retrospective cohort study

  • Orthopaedic Surgery
  • Published:
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Abstract

Introduction

Trochanteric fractures are one of the most common fragility fractures, and the number of the patients is increasing worldwide. Identifying prognostic factors is important to manage and minimize the social losses caused by postoperative walking impairment. The purpose of this retrospective study is to clarify the association between early postoperative Barthel index score and postoperative long-term walking ability among patients with trochanteric fractures who could walk independently before injury.

Materials and methods

Consecutive patients with trochanteric fractures aged ≥ 65 years who were walking independently before injury were included. Patients were divided into two groups according to the Barthel index score measured within 1 week after surgery; the cut-off value was set at 20 points. The prevalence of walking impairment after 1 year was compared between these two groups after adjusting for confounding factors in a complete case analysis and using the data introduced by the multiple imputation method.

Results

Among the 758 eligible patients, 254 patients (34%) had their walking ability evaluated after 1 year from injury. The patients in the lower Barthel index group showed a significantly impaired walking ability in both analyses (adjusted odds ratio 5.5 and 2.4, 95% confidence intervals 2.4–13 and 1.5–3.8, respectively).

Conclusions

The present results suggested that the Barthel index score measured in the early postoperative period after trochanteric fractures was associated with the level of long-term walking impairment in patients who could walk independently before injury.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 1738606, Japan

    Takahiro Inui, Yoshinobu Watanabe, Kentaro Matsui & Hirotaka Kawano

  2. Trauma and Reconstruction Center, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 1738606, Japan

    Takahiro Inui, Yoshinobu Watanabe, Takashi Suzuki, Kentaro Matsui, Keisuke Ishii & Taketo Kurozumi

  3. Division of Orthopaedic Trauma, Sapporo Tokushukai Hospital, 1-1-1 Oyachi-higashi, Atsubetsu-ku, Sapporo, Hokkaido, Japan

    Yoshiaki Kurata

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  1. Takahiro Inui
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  2. Yoshinobu Watanabe
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  4. Takashi Suzuki
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Contributions

Conceptualization, Methodology and Formal analysis and investigation: TI; Writing—original draft preparation: TI, YW and TS; Writing—review and editing: KM and KI; Supervision: TK and HK. Early postoperative Barthel index score and long-term walking ability in patients with trochanteric fractures walking independently before injury: a retrospective cohort study.

Corresponding author

Correspondence to Takahiro Inui.

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Conflicts of interest

Each author certifies that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Ethical approval

This retrospective investigation was performed at Sapporo Tokushukai Hospital. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The research protocol was approved by the institutional review board of Teikyo University and Sapporo Tokushukai Hospital.

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Inui, T., Watanabe, Y., Kurata, Y. et al. Early postoperative Barthel index score and long-term walking ability in patients with trochanteric fractures walking independently before injury: a retrospective cohort study. Arch Orthop Trauma Surg 141, 1283–1290 (2021). https://doi.org/10.1007/s00402-020-03548-7

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  • DOI: https://doi.org/10.1007/s00402-020-03548-7

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