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Table 4 Impact of intervention four and twelve months after surgery

From: The effect of a pre- and postoperative orthogeriatric service on cognitive function in patients with hip fracture: randomized controlled trial (Oslo Orthogeriatric Trial)

 

Four months follow up

 

Twelve months follow up

 

Outcome

Acute geriatric ward (n = 121)

Orthopedic ward (n = 121)

P-value

Acute geriatric ward (n = 98)

Orthopedic ward (n = 95)

P-value

Primary outcome, mean (SD)a

54.7 (30.3)

52.9 (29.1)

0.65

51.0 (33.4)

49.1 (32.3)

0.69

CERAD 10 word test, median (IQR)

      

- immediate recall,

12.5 (6 to 17)

11.5 (5.3 to 18)

0.77

11.5 (5 to 18)

11 (5 to 17.8)

0.89

- delayed recall

3 (0 to 6)

2 (0 to 5)

0.35

3 (0 to 6)

2.5 (0 to 5)

0.41

- recognition

18 (13.4 to 19)

17.5 (13 to 19.8)

0.93

17 (11 to 20)

17 (12 to 20)

0.93

CDR sum of boxes, median (IQR)

1.5 (0 to 9)

2.5 (0 to 9.5)

0.39

1.75 (0 to 14)

2.5 (0 to 14)

0.52

MMSE, median (IQR)b

24 (16 to 28)

23 (16 to 27)

0.28

24 (16.3 to 27)

22 (13.3 to 26)

0.34

Approved clock drawing test (%)c

48 (49)

42 (40)

0.20

39 (46)

28 (35)

0.12

NEADL, median (IQR)d

26.5 (7.8 to 50.3)

22 (9 to 46.5)

0.85

25 (8.8 to 51)

18 (10 to 47)

0.65

BADL, median (IQR)e

17 (10 to 20)

16 (12 to 20)

0.80

17 (9.5 to 19)

16 (11 to 19)

0.44

SPPB, median (IQR)f

4 (1 to 8)

3 (1 to 6)

0.13

3 (1 to 7)

3 (1 to 6)

0.14

IQCODE, median (IQR)g

3 (3 to 3.25)

3 (3 to 3.19)

0.74

3.69 (3 to 5)

3.75 (3.13 to 4.94)

0.45

Weight change from index stay in kg, mean (SD)h

- 3.4 (4.3)

- 4.4 (5.0)

0.25

- 2.4 (6.3)

- 3.4 (7)

0.43

New nursing home admissions (%)

19 (16)

18 (15)

0.86

16 (16)

18 (19)

0.63

Incident dementiai

   

7 (7)

3 (3)

0.33

Re-admissions

21 (17)

21 (17)

0.95

32 (33)

33 (35)

0.76

  1. aTo construct the primary outcome, we normalized CDR and the 10 word test from CERAD into a 0 to 100 scoring (CDR had to be reversed since it is scaled in the opposite direction). CDR weighed 50% and the immediate and delayed recall parts of the 10 word test weighed 25% each in the combined measure. The primary outcome was missing in nine patients from the acute geriatric ward and five patients from the orthopedic ward at four months and in four patients from the acute geriatric and three from the orthopedic ward at twelve months; bMMSE was missing in 11 patients from the acute geriatric ward and in nine patients from the orthopedic ward at the four-month control and in six and three patients, respectively, at the 12-months control; c ≥ 4 points. Clock drawing test was missing in 23 patients from the acute geriatric ward and in 16 patients from the orthopedic ward at the four-month control and 14 and 14 patients, respectively, at the 12-month control; dNEADL was missing in seven patients from the acute geriatric ward and in eight from the orthopedic ward at the four-month control and in two patients from the orthopedic ward from the 12-month control; eBarthel ADL was missing in two patients from the acute geriatric ward and in one from the orthopedic ward at four months and in one and two patients, respectively, at the 12-month control; fSPPB was missing in seven patients from the acute geriatric ward and two from the orthopedic ward at four months and in five and three patients, respectively, at the 12-month control; ga modified version of IQCODE was used at the four-month control; instead of asking for changes in the last 10 years, we asked for changes since just before the hip fracture. At the 12-month control we used the regular IQCODE. This was missing in two patients from the acute geriatric ward and three from the orthopedic ward at the four-month control and in three and four patients, respectively, at the 12-month control; hweight was missing in 33 patients from the acute geriatric ward and 29 patients from the orthopedic ward at the four-month control and in 19 and 22 patients, respectively, at the 12-month control; ibased upon consensus in an expert panel (TBW and KE). BADL, Barthel Activities of Daily Living; CDR, The Clinical Dementia Rating scale; CERAD, Consortium to Establish a Registry for Alzheimer’s Disease; IQCODE, Informant Questionnaire on Cognitive Decline in the Elderly; IQR, interquartile range; MMSE, Mini Mental State Examination; NEADL, Nottingham Extended ADL Index; SD, standard deviation; SPPB, Short Physcial Performance Battery.
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BMC Medicine

ISSN: 1741-7015

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