Functional Recovery Predictors in Hip Fractures: Insights from a Community Clinical Pathway

<b>Background:</b> Osteoporotic hip fractures in the elderly significantly impact mobility and quality of life. Optimising early management is crucial for improving the functional outcomes. <b>Methods:</b> This single-centre retrospective cohort study included patients with femoral trochanteric (n = 142) or femoral neck fractures (n = 127) treated between January 2016 and March 2023. The patients were divided into ambulatory and non-ambulatory groups based on their walking ability at discharge from the rehabilitation hospital. The explanatory variables included age, sex, fracture type, surgical method, pre-surgical days, hospital days, dementia, and the Nursing Needs Score (NNS). <b>Results:</b> The most common age group was 85-89 years old. Only 23.4% of patients underwent surgery within 2 days of admission. The median hospital stay was 20 days in acute care and 52 days in rehabilitation hospitals. Walking ability declined in 66.9% of the patients. Pre-injury mobility and acute care hospital NNS were identified as independent predictors of ambulatory outcomes. <b>Conclusions:</b> Pre-injury mobility and the Nursing Needs Score (NNS) assessed at the acute care hospital were identified as critical determinants of postoperative ambulatory status. These findings highlight the importance of community collaboration and preventive rehabilitation strategies aimed at improving basic mobility, maintaining cognitive function, and preserving walking ability.