The main purpose of this retrospective cohort study was to examine the relationship between total walking distance on the first day of walking after surgery for hip fracture and walking status at discharge in the elderly. The inclusion criteria were age 65 years or older and ability to walk independently with or without a walking aid before the injury. Sex, age at admission, fracture type, type of surgical procedure, Revised Hasegawa Dementia Scale score, time from surgery to the first day of walking, total walking distance on the first day of walking, walking status at discharge, and length of hospitalization were investigated from the electronic medical records. We then examined the investigated the relationship between walking status at discharge and total walking distance on the first day of walking after surgery. Mean age of the patients was 79.5 years, and 6 patients had cognitive impairment. A total of 12 patients were able to walk 50m at discharge. In bivariate logistic regression analysis, total walking distance on the first day of walking was found to be a significant predictor of walking status. Therefore, total walking distance on the first day of walking after hip fracture surgery appears to be a useful predictor for the walking status at discharge in Japanese general hospitals.

The objective of this study was to determine whether a decrease in the score for any of the Functional Independence Measure (FIM) domains at discharge compared to before admission (decreased FIM) is associated with increased risk of facility admission. Patients were divided into those discharged to a care facility (facility group) and those discharged home (home group). Patients in the home group were selected so as to match those in the facility group. A total of 36 patients were included in each group. Mean ages of patients in the home and facility groups were 88.9 ± 7.9 and 89.1 ± 7.6 years, respectively, and mean pre-admission total FIM scores were 77.1 ± 29.8 and 78.5 ± 30.3, respectively. When each FIM subdomain was examined for correlation between decreased score and post-discharge destination, bowel management (odds ratio, 4.5), bladder management (3.9), social interaction (3.5), problem solving (3.5), and walking (2.5) were identified as being significantly associated with increased risk of facility admission. A limitation was that this study did not consider the care-giving capacity of families. Further studies are needed to identify additional potential factors affecting post-discharge destination, including care-giving capacity of families and other social factors.