Advanced prediction of functional outcomes in hip fracture patients using premorbid functional assessments

Purpose: This historical cohort study aims to determine the relationship between premorbid functional status and functional decline in hip fracture patients. Methods: Eighty-two hip fracture patients were divided into Group A (good rehabilitation potential) and Group B (fair rehabilitation potential) based on four premorbid functional assessments: Modified Functional Ambulation Category (MFAC), Modified Barthel Index (MBI), Hong Kong Montreal Cognitive Assessment 5-Minute and functional prognosis predictive score. Declines in MFAC and MBI after rehabilitation were compared. Results: Sixty-seven percent of patients in Group A had up to one category decline in final MFAC, whereas 66% in Group B had more than one category decline. Similarly, median decline in final MBI was seven in Group A versus 22 in Group B. Conclusion: Hip fracture patients with good rehabilitation potential have significantly fewer functional declines. It is possible for them to be directly discharged from acute hospital for outpatient rehabilitation.