Three Care Models for Elderly Patients With Hip Fracture

Hip Fracture Clinical Trial

Official title:

Three Care Models for Elderly Patients With Hip Fracture

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01350557
• Other study ID #: NHRI-EX98-9404PI
• Secondary ID: HMRPD180015
• Status: Completed
• Phase: N/A
• First received: May 6, 2011
• Last updated: February 2, 2017
• Start date: January 2005
• Est. completion date: July 2010

Study information

• Verified date: February 2017
• Source: Chang Gung Memorial Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Hip fracture in the elderly is associated with excess mortality of 5 to 20%, and mobility problems that usually results in costly hospital stays and lengthy rehabilitation procedures. The purpose of this study is to compare the costs and effectiveness of three care models- acute/sub-acute, comprehensive, and routine care models for hip fractured elders in Taiwan.

Description:

Hip fracture in the elderly is associated with excess mortality of 5 to 20%, and mobility problems that usually results in costly hospital stays and lengthy rehabilitation procedures. With this increase in the aging population, hip fracture represents a major and a fast growing health care problem in Taiwan. Currently, the incidence rate of hip fractures is 10 times of the incidence rate for the general population. Despite the use of advanced treatment, the one-year mortality rate (15.4%) remains significant, and many of the patients never recover completely in terms of activities of daily living functions. Many studies in the United States have proved that elderly patients with hip fracture can benefit from post-operative rehabilitation, early discharge planning programs, or transitional care programs. However, little is known about what intervention should be attempted for these patients and their families in Taiwan.

The purpose of this study is to compare the costs and effectiveness of three care models- acute/sub-acute, comprehensive, and routine care models for hip fractured elders in Taiwan.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 299
• Est. completion date: July 2010
• Est. primary completion date: September 2005
• Accepts healthy volunteers: No
• Gender: All
• Age group: 60 Years and older

Eligibility

Inclusion Criteria:

• Age 60 years or older

• Admitted to hospital for an accidental single-side hip fracture

• Receiving hip arthroplasty or internal fixation

• Able to perform full range of motion against gravity and against some or full resistance, and have a pre-fracture Chinese Barthel Index (CBI) score >70

• Living in northern Taiwan

Exclusion Criteria:

• Severely cognitively impaired and completely unable to follow orders (determined by a Chinese Mini-Mental State Examination [MMSE] score <10), or

• Terminally ill

Related Conditions & MeSH terms

• Fractures, Bone
• Hip Fracture
• Hip Fractures

Intervention

Other:
• Comprehensive care
Comprehensive care consisted of subacute care plus health-maintenance interventions to manage depressive symptoms, manage malnutrition, and prevent falls.
• Subacute care
Subacute care included geriatric consultation, continuous rehabilitation, and discharge planning.

Locations

Country	Name	City	State
Taiwan	Chang Gung Memorial Hospital	Taoyuan

Sponsors (2)

Lead Sponsor	Collaborator
Chang Gung Memorial Hospital	National Health Research Institutes, Taiwan

Country where clinical trial is conducted

Taiwan, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Self-care ability	Measured by the Chinese Barthel Index (CBI) as ability to perform activities of daily living (ADLs), with scores ranging from 0 to 100.	1, 3, 6, 12 months after hospital discharge
Secondary	Depressive symptoms	Depressive symptoms were assessed using the Chinese version of the Geriatric Depression Scale, short form (GDS-s). Patients with a score = 5 were categorized as at risk for clinical depression.	1, 3, 6, 12 months after hospital discharge
Secondary	Nutritional status	Nutritional status was assessed using the Mini Nutritional Assessment (MNA). MNA scores categorize each person as well-nourished (=24 points), at risk of malnutrition (17-23.5 points), and malnourished (<17 points).	1, 3, 6, 12 months after hospital discharge