Recovery of walking ability in patients with exceptional longevity after hip fracture: Predictors and short-and long-term survival in relation to recovery of walking

Background There are very few studies on walking recovery and its predictors in extremely older patients after a hip fracture. Relationship between walking recovery and survival has not been studied in this age group either. The objective of our study is to assess walking recovery and its predictors in extremely older patients at 6 months after discharge, and whether there was a relationship with short and long-term survival. Methods Restrospective review including all patients older than 95 years admitted with a fragility hip fracture between December 2009 and September 2015 in a tertiary university hospital in Barcelona. Walking ability was measured by the functional ambulation classification (FAC) prior to admission and at 6 months after discharge. Short- and long-term survival were recorded. Results One hundred and fifty-two patients were included. Before the fracture, 78.3% of patients were independent in ambulation, whereas this percentage dropped to 36.8% afterward. This means that 46.9% of those who previously walked independently regained their ability to do so. Better previous FAC (p < 0.001, OR 3.658), not having delirium during admission (p = 0.010, OR 3.45), and being able to carry out full weight-bearing (p = 0.026, OR 12.705) were the variables associated with better walking recovery. Area under the ROC curve was 0.819 (p < 0.001). Mean survival after discharge was 2.24 years (SD 1.185). Patients with post-fracture FAC > 3 had better survival. Conclusion Walking recovery predictors in patients with exceptional longevity were: having better previous FAC, being able to carry out full weight-bearing, and not having delirium. Patients able to walk without help during the first six months after discharge had a better survival.