Table 2.
Discharge by timing of mobilisation among patients surgically treated for non-pathological first hip fracture for subgroups defined by dementia, delirium, hypotension, prefracture ambulation and prefracture residence
| Mobilisation timing | No. of patients | No of deathsa | No. of live dischargesb | Live discharge rate (95% CI)c | 30-day CIF, c (95% CI) | p-value§ | Unadjusted OR of CIF (95% CI) | Adjusted OR of CIF (95% CI)d |
|---|---|---|---|---|---|---|---|---|
| patients with dementia | ||||||||
| Overall | 34,253 | 17,083 | 2171 | 31.9 (31.4–32.4) | 630 (624–636) | |||
| Mobilised late | 9443 | 4179 | 992 | 26.8 (26–27.6) | 545 (534–557) | 1.00 | 1.00 | |
| Mobilised early | 24,810 | 12,904 | 1179 | 34 (33.4–34.6) | 664 (656–671) | < 0.001 | 1.72 (1.62–1.82) | 1.83 (1.70–1.97) |
| patients without dementia | ||||||||
| Overall | 80,442 | 43,017 | 2683 | 42.4 (42.0–42.8) | 749 (745–753) | |||
| Mobilised late | 14,700 | 5874 | 1179 | 26.2 (25.5–26.9) | 574 (564–585) | 1.00 | 1.00 | |
| Mobilised early | 65,742 | 37,143 | 1504 | 46.9 (46.5–47.4) | 791 (787–795) | < 0.001 | 2.67 (2.57–2.77) | 2.28 (2.17–2.39) |
| patients with delirium | ||||||||
| Overall | 9818 | 4010 | 775 | 23.9 (23.2–24.7) | 537 (526–549) | |||
| Mobilised late | 2746 | 929 | 336 | 19 (17.8–20.3) | 436 (414–458) | 1.00 | 1.00 | |
| Mobilised early | 7072 | 3081 | 439 | 26 (25.1–26.9) | 578 (564–592) | < 0.001 | 1.94 (1.72–2.19) | 1.84 (1.59–2.13) |
| patients without delirium | ||||||||
| Overall | 104,877 | 56,090 | 4079 | 40.6 (40.2–40.9) | 727 (723–730) | |||
| Mobilised late | 21,397 | 9124 | 1835 | 27.5 (27–28.1) | 578 (57–587) | 1.00 | 1.00 | |
| Mobilised early | 83,480 | 46,966 | 2244 | 44.7 (44.2–45.1) | 768 (764–772) | < 0.001 | 2.40 (2.32–2.48) | 2.16 (2.07–2.26) |
| patients with hypotension | ||||||||
| Overall | 10,123 | 4425 | 759 | 28.1 (27.3–28.9) | 599 (587–611) | |||
| Mobilised late | 2825 | 939 | 391 | 19.9 (18.7–21.2) | 448 (426–47) | 1.00 | 1.00 | |
| Mobilised early | 7298 | 3486 | 368 | 31.5 (30.5–32.6) | 661 (647–675) | < 0.001 | 2.39 (2.14–2.66) | 2.11 (1.85–2.42) |
| patients without hypotension | ||||||||
| Overall | 104,572 | 55,675 | 4095 | 40.0 (39.6–40.3) | 720 (716–723) | |||
| Mobilised late | 21,318 | 9114 | 1780 | 27.4 (26.8–27.9) | 576 (568–584) | 1.00 | 1.00 | |
| Mobilised early | 83,254 | 46,561 | 2315 | 43.9 (43.5–44.3) | 76 (756–763) | < 0.001 | 2.36 (2.28–2.44) | 2.12 (2.03–2.22) |
| patients with indoor ambulation only prefracture | ||||||||
| Overall | 30,834 | 14,200 | 2189 | 30.2 (29.7–30.7) | 611 (604–618) | |||
| Mobilised late | 9171 | 3742 | 1099 | 25.1 (24.3–25.9) | 523 (511–535) | 1.00 | 1.00 | |
| Mobilised early | 21,663 | 10,458 | 1090 | 32.6 (32.0–33.2) | 651 (643–659) | < 0.001 | 1.82 (1.72–1.93) | 1.78 (1.65–1.92) |
| patients with outdoor ambulation prefracture | ||||||||
| Overall | 100,983 | 55,344 | 3265 | 42.5 (42.1–42.8) | 746 (743–750) | |||
| Mobilised late | 18,064 | 7696 | 1312 | 27.6 (27–28.2) | 588 (579–597) | 1.00 | 1.00 | |
| Mobilised early | 82,919 | 47,648 | 1953 | 46.5 (46.1–47.0) | 784 (780–787) | < 0.001 | 2.48 (2.4–2.57) | 2.28 (2.18–2.4) |
| patients admitted from residential care | ||||||||
| Overall | 23,588 | 16,252 | 1428 | 50.5 (49.7–51.2) | 779 (773–784) | |||
| Mobilised late | 7065 | 4448 | 674 | 42.7 (41.4–43.9) | 707 (696–719) | 1.00 | 1.00 | |
| Mobilised early | 16,523 | 11,804 | 754 | 54.2 (53.2–55.2) | 810 (803–817) | < 0.001 | 1.68 (1.59–1.79) | 1.64 (1.51–1.77) |
| patients admitted from home | ||||||||
| Overall | 107,144 | 53,284 | 3938 | 37.3 (37.0–37.6) | 700 (696–703) | |||
| Mobilised late | 19,779 | 6977 | 1694 | 22.1 (21.6–22.6) | 512 (530–521) | 1.00 | 1.00 | |
| Mobilised early | 87,365 | 46,307 | 2244 | 41.6 (41.2–42.0) | 746 (742–749) | < 0.001 | 2.85 (2.75–2.96) | 2.30 (2.19–2.41) |
Abbreviations: CIF Cumulative incidence function, CI Confidence interval, OR Odds ratio
aAt 30 days from surgery bAt 30 days from surgery cPer 1000 patient–days. § Pepe-Mori test p-value. Two–sample test compared to mobilised 2 days or more after surgery dAdjusted for age, sex, ethnicity, fracture type, calendar period of admission, timing of surgery, comorbidity (in each subgroup analysis by hypotension, dementia, delirium the corresponding variable is excluded from the adjustment), prefracture residence (except for analysis by prefracture residence subgroup), prefracture ambulation (except for the analysis by prefracture ambulation subgroup), procedure type, day of admission and hospital volume. CIF regression at in-patient days 3, 4, 6, 8, 12, 16, 20, 24, and 30. Results based on a subset of patients with known information for adjustment variables. The analysis of patients with imputation for missing values in adjustment variables is available in supplementary file 4