Observational study for multidimensional assessment in elderly patients hospitalized for post-fracture or elective surgery and functional rehabilitation

Fracture-related hospitalizations are frequent in older adults, with recovery often extended. This study evaluated the prognostic utility of the Multidimensional Prognostic Index (MPI), Handgrip Strength (HGS), Short Physical Performance Battery (SPPB), and Geriatric Depression Scale (GDS) in predicting adverse outcomes-hospitalizations, falls, or mortality-after femoral fracture or total knee arthroplasty surgery. The methods adopted were MPI assessed frailty, SPPB measured physical performance, GDS identified depression, and HGS evaluated muscle strength. Receiver Operating Characteristic (ROC) curves determined their predictive value for adverse outcomes. The study included 206 older adults (mean age 77.5, 79.6% female). At 6 months post-surgery, significant improvements were seen in SPPB (+4.35) and HGS (+1.36 kg), with notable gains among frail patients. MPI scores declined (-0.15), and Walking Test improved (+1.92). MPI showed the strongest predictive power (AUC 0.89). Higher MPI (HR 3.47) and lower HGS (HR 0.88) were significantly associated with mortality. Male sex also increased mortality risk (HR 5.99). MPI and HGS effectively predicted adverse outcomes over 6 months, supporting their use in risk stratification for older adults' post-surgery for fractures or total knee arthroplasty surgery.