Ann Rehabil Med.  2019 Oct;43(5):562-569. 10.5535/arm.2019.43.5.562.

Relationship Between Performance Improvement in Activities of Daily Living and Energy Intake in Older Patients With Hip Fracture Undergoing Rehabilitation

• Umezawa H
• Kokura Y
• Abe S
• Suzuki C
• Nishida A
• Uchiyama Y
• Maeda K
• Wakabayashi H
• Momosaki R

• KMID: 2463704
• DOI: http://doi.org/10.5535/arm.2019.43.5.562

Abstract

OBJECTIVE
To analyze whether sufficient energy intake (EI) improves performance of activities of daily living (ADL) in patients with hip fracture admitted to rehabilitation hospitals. The adequate amount of EI for improving performance of ADL in patients with hip fracture remains unknown.
METHODS
This retrospective cohort study included all patients with hip fracture (n=234) admitted to rehabilitation hospitals in Japan. The inclusion criteria for this study were age >65 years and body mass index <30.0 kg/m². Patients who were transferred to an acute hospital and those with missing case data were excluded. According to the amount of EI, the patients were classified into energy sufficiency and shortage groups (EI/total energy expenditure ≥1.0 and <1.0, respectively). The Functional Independence Measure (FIM) and FIM gain were used to evaluate the patient disability level and change in patient status in response to rehabilitation. Finally, FIM gain was calculated as the discharge FIM score minus the admission FIM score.
RESULTS
The final analysis targeted 202 patients"”53 (26.2%) were in the energy shortage group and 149 (73.8%) were in the energy sufficiency group. The energy sufficiency group had a greater FIM gain than the energy shortage group (mean, 25.1±14.2 vs. 19.7±16.4; p=0.024). Furthermore, sufficient EI in the first week since admission (β=0.165; 95% confidence interval, 0.392-5.230; p=0.023) was an independent factor of FIM gain.
CONCLUSION
Among elderly patients with hip fracture admitted to rehabilitation hospitals in Japan, the amount of EI during the first week after admission was an independent factor of FIM gain.

Keyword

Femoral fractures; Hospitals; Rehabilitation; Nutritional support; Recovery of function

MeSH Terms

Activities of Daily Living*
Aged
Body Mass Index
Cohort Studies
Energy Intake*
Energy Metabolism
Femoral Fractures
Hip*
Humans
Japan
Nutritional Support
Recovery of Function
Rehabilitation*
Retrospective Studies

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