Prognosis of functional recovery 1 year after hip fracture: Typical patient profiles through cluster analysis

Citation
Jp. Michel et al., Prognosis of functional recovery 1 year after hip fracture: Typical patient profiles through cluster analysis, J GERONT A, 55(9), 2000, pp. M508-M515
Citations number
15
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Public Health & Health Care Science","Medical Research General Topics
Journal title
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES
ISSN journal
1079-5006 → ACNP
Volume
55
Issue
9
Year of publication
2000
Pages
M508 - M515
Database
ISI
SICI code
1079-5006(200009)55:9<M508:POFR1Y>2.0.ZU;2-E
Abstract
Background. Many investigators have identified distinct medical, demographi c and psychosocial prefracture conditions that influence the functional out come of patients surgically treated for a fracture of the hip. However, to design efficient intervention care programs addressing the needs of these p atients, at optimal economic and social costs, more information is required on the typical combinations of prognostic determinants actually encountere d. Methods. Data on specific descriptors of the prefracture status and on mobi lity and functioning 1 year after surgical intervention were collected by i nterview from 253 consecutive patients hospitalized for a fracture of the p roximal femur. Cluster analysis was used to form homogeneous groups of pati ents with similar profiles in terms of the 13 predictive variables and the 7 outcome variables significantly interrelated. The modeling procedure gene rated Four clusters of patients with a typical profile sharply contrasted b y their structure. Results. subjects of two clusters could walk without difficulty and were fu nctionally independent prior to their hip fracture. One year later, however , mobility and functioning were only fully recovered by the members of one cluster. The majority of predictors were of less favorable prognostic value for the members of the second cluster. The other two clusters regrouped pa tients with impaired prefracture mobility that were either unaltered or eve n aggravated I year later. Conclusions. Cluster analysis identified typical profiles of elderly hip fr acture patients. Close scrutiny of their respective global structure, in te rms of combined prognostic determinants and outcomes, may help to develop s pecific management strategies that are more efficiently adapted to these di fferent group of patients.