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The characteristics of elderly hip fracture patients in acute care hospitals were analyzed based on hospitalization and discharge route and the presence or absence of a dementia diagnosis. The study was conducted as a cross-sectional exploratory study using data from the Diagnosis Procedure Combination database in Japan from April 2014 to March 2016. Patients aged 65 years or older who had surgery for a hip fracture were identified. We subsequently extracted patients whose home, medical institution (including convalescent rehabilitation wards), or elderly care facility was both the admission and discharge route. A total of 105 122 patients were included. 19% of patients were diagnosed with dementia. Patients with dementia had a shorter length of acute care hospital stay than those without dementia. The hospitalization route for dementia patients was 51% at home and 40% at a care facility. Dementia patients were discharged to hospital and care facilities at 41% each. Nearly all patients received hospital-based postoperative rehabilitation regardless of dementia but patients with dementia had lower gains in activities of daily living. Hip fracture patients with dementia have less opportunity for continuous hospital-based rehabilitation and need an environment that allows for continuous elderly care facility-based and community-based rehabilitation. In Japan, an aging society, one in five elderly patients undergoing hip fracture surgery was diagnosed with dementia. Many hip fracture patients with dementia have a shorter length of hospital stay and may have fewer opportunities to change hospitals to receive rehabilitation. It is necessary to establish an ongoing and proactive community- and elderly care facility-based rehabilitation system for patients with hip fracture with dementia after acute care hospital discharge. [ABSTRACT FROM AUTHOR]

Objectives: The current research aimed to study the relationship between health‐related quality of life (poor perceived health/unhealthy days) and workers' pain. Methods: This cross‐sectional study was conducted among 1360 Japanese workers of a Japanese company in Kyushu. Health‐related quality of life was measured by HRQOL‐4 tool developed by Centers for Disease Control and Prevention of the USA. Pain was assessed by numeric rating scale with 0‐10 points. Regression analysis was conducted to identify the relationship between health‐related quality of life and pain. Results: Participants who reported pain had significantly greater odds of having poor health compared to those with no pain (AOR = 3.99, 95% CI = 3.82‐4.18, P <.0001). In general, participants who had a higher frequency and intensity of pain had significantly greater odds of having poor health compared to those with no pain. Compared to those with no pain, participants with pain had an average of 2.85 (95% CI = 2.07‐3.63, P <.0001), 2.25 (95% CI = 1.52‐2.99, P <.0001), 4.41 (95% CI = 3.39‐5, P <.0001), and 1.9 (95% CI = 1.30‐2.50, P <.0001) more physically unhealthy days, mentally unhealthy days, total unhealthy days, and days with activity limitation, respectively. Headache causes many more unhealthy days and more poor health than any other pain, including back pain, shoulder/neck pain, and joint pain. Conclusion: Poor health status and the number of unhealthy days among Japanese workers are strongly associated with the presence of pain and increases with the intensity and frequency of pain. [ABSTRACT FROM AUTHOR]

The present study evaluated the risk of mortality in elderly hip fracture, focusing on comorbidities and nursing care levels. The present study was an observational cohort study that used a combined database of medical and long-term care insurance (LTCI) claims data from one prefecture in Japan between 2011 and 2016. In total, 6125 patients aged 65 years and older were selected from acute care hospitals with a diagnosis of "hip fracture" between March 2011 and March 2012. The impact of long-term care insurance claim evaluation levels and comorbidities at recruitment time was investigated using this dataset. These patients were followed up monthly until March 2016. Based on this person-month dataset, survival analysis was performed with death as the endpoint. Cases in which receipt data were missing during the middle of the observation period and cases in which the patient survived at the end of the observation period were censored. The number of deaths during the observation period was 635 (10.4%). The impact of comorbidities and nursing care level on mortality were both significant as follows: high nursing care level before the fracture (hazard ratio: 1.09, P < 0.001), comorbidities of malignant diseases (HR: 1.45, P < 0.001), heart disease (hazard ratio: 1.20, P = 0.037), pneumonia (hazard ratio: 1.27, P < 0.001), chronic obstructive pulmonary disease (hazard ratio: 1.28, P = 0.026), renal failure (hazard ratio: 1.44, P < 0.001), and dementia (hazard ratio: 1.27, P = 0.013). The results of this study showed that a high level of nursing care and presence of comorbidities such as malignant diseases, heart diseases, pneumonia, chronic obstructive pulmonary disease, renal failure, and dementia increased mortality in elderly patients with hip fracture. Furthermore, this study showed the usefulness of a combined database of medical and LTCI claims data for clinical and health service-related research in the field of orthopedics. [ABSTRACT FROM AUTHOR]