Purpose: To examine the association between physiotherapy in the first week after hip fracture surgery and discharge from acute hospital.
Methods: We linked data from the UK Physiotherapy Hip Fracture Sprint Audit to hospital records for 5,395 patients with hip fracture in May and June 2017. We estimated the association between the number of days patients received physiotherapy in the first postoperative week, its overall duration (<2 hours, ≥2 hours; 30-minute increment) and type (mobilisation alone, mobilisation and exercise) and the cumulative probability of discharge from acute hospital over 30-days, using proportional odds regression adjusted for confounders and the competing risk of death.
Results: The crude and adjusted odds ratios of discharge were: 1.24 (95% CI 1.19–1.30) and 1.26 (95% CI 1.19–1.33) for an additional day of physiotherapy, 1.34 (95% CI 1.18-1.52) and 1.33 (95% CI 1.12-1.57) for ≥ 2 hours versus < 2 hours physiotherapy, and 1.11 (95% CI 1.08-1.15) and 1.10 (95% CI 1.05-1.15) for an additional 30-minutes of physiotherapy. Physiotherapy type was not associated with discharge.
Conclusion: We report an association between physiotherapy and discharge after hip fracture. An average UK hospital admitting 375 patients annually may save 456 bed-days if current provision increased so all patients with hip fracture received physiotherapy on 6-7 days in the first postoperative week. A seven-day physiotherapy service totalling at least two hours in the first postoperative week
may be considered a key performance indicator of acute care quality after hip fracture.
- Neck of Femur
- Hip fracture
- National Hip Fracture Database