Diabetes Comorbidity and Age Influence Rehabilitation Outcomes After Hip Fracture
- Timothy A. Reistetter, PHD, OTR1,2,
- James E. Graham, PHD, DC2,
- Anne Deutsch, PHD, CRRN3,
- Samuel J. Markello, PHD4,
- Carl V. Granger, MD4,5 and
- Kenneth J. Ottenbacher, PHD, OTR2⇓
- 1Department of Occupational Therapy, University of Texas Medical Branch, Galveston, Texas
- 2Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, Texas
- 3Rehabilitation Institute of Chicago, Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- 4Uniform Data System for Medical Rehabilitation, UB Foundation Activities, Inc., Buffalo, New York
- 5Department of Rehabilitation Medicine, University at Buffalo, Buffalo, New York
- Corresponding author: Kenneth J. Ottenbacher, .
OBJECTIVE To examine the influence of diabetes on length of stay (LOS), functional status, and discharge setting in individuals with hip fracture.
RESEARCH DESIGN AND METHODS This work included secondary analyses of 79,526 individuals from 915 rehabilitation facilities in the U.S. Patients were classified into three groups using the Centers for Medicare and Medicaid Services comorbidity structure: individuals without diabetes (77.0%), individuals with non-tier diabetes (18.3%), and individuals with tier diabetes (4.7%).
RESULTS Mean age was 79.4 years (SD 9.6), and mean LOS was 13.3 days (SD 5.3). Tier diabetes was associated with longer LOS, lower functional status ratings, and reduced odds of discharge home when compared with individuals with no diabetes and non-tier diabetes. Statistically significant interactions (P < 0.05) were found between age and diabetes classification for LOS, functional status, and discharge setting.
CONCLUSIONS The impact of diabetes on recovery after hip fracture is moderated by age.
- Received November 24, 2010.
- Accepted March 17, 2011.
- © 2011 by the American Diabetes Association.
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.