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Early mobilisation after hip fracture surgery is associated with improved patient outcomes: A systematic review and meta-analysis.
Agarwal, Nikhil; Feng, Tony; Maclullich, Alasdair; Duckworth, Andrew; Clement, Nicholas.
Afiliación
  • Agarwal N; Division of Trauma & Orthopaedic Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.
  • Feng T; Division of Trauma & Orthopaedic Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.
  • Maclullich A; Division of Geriatric Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK.
  • Duckworth A; Division of Trauma & Orthopaedic Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.
  • Clement N; Division of Trauma & Orthopaedic Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.
Musculoskeletal Care ; 22(1): e1863, 2024 Mar.
Article en En | MEDLINE | ID: mdl-38353351
ABSTRACT

INTRODUCTION:

The aims of this systematic review and meta-analysis were to determine if after hip fracture surgery (1) early mobilisation is associated with improved clinical outcomes, and if so (2) are benefits directly proportional to how soon after surgery the patient mobilises.

METHODS:

A Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic review was conducted using four databases to identify all studies that compared postoperative early mobilisation with delayed mobilisation, in patients after hip fracture surgery. The Critical Appraisal Skills Programme checklist was employed for critical appraisal and evaluation of all studies that met the inclusion criteria.

RESULTS:

A total of 13 studies, including 297,435 patients were identified, of which 235,275 patients were mobilised early and 62,160 were mobilised late. Six studies assessed 30-day mortality, of which two also investigated 30-day complication rates. Pooled meta-analysis demonstrated that there were significantly lower 30-day mortality rates (odds ratio [OR] 0.35, 95% confidence interval [CI] 0.31-0.41, p < 0.001) and complication rates (OR 0.43, 95% CI 0.36-0.51, p < 0.001) in patients mobilising early after hip fracture surgery. Five studies investigated length of stay (LOS) and meta-analysis revealed no difference between groups (mean difference -0.57 days, 95% CI -1.89-0.74, p = 0.39).

CONCLUSION:

Early mobilisation in hip fracture patients is associated with a reduction in 30-day mortality and complication rates compared to delayed mobilisation, but no difference in LOS. These findings illustrate that early mobilisation is associated with superior post operative outcomes. However, a direct casual effect remains to be demonstrated, and further work on the factors underlying delayed mobilisation is required.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ambulación Precoz / Fracturas de Cadera Tipo de estudio: Evaluation_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Musculoskeletal Care Asunto de la revista: FISIOLOGIA / ORTOPEDIA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ambulación Precoz / Fracturas de Cadera Tipo de estudio: Evaluation_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Musculoskeletal Care Asunto de la revista: FISIOLOGIA / ORTOPEDIA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido