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Neuropsychiatric Symptoms and Rehabilitation Outcomes in Patients with Hip Fracture

Gialanella, Bernardo MD; Prometti, Paola MD; Monguzzi, Vittoria MD; Ferlucci, Cristina MD

American Journal of Physical Medicine & Rehabilitation: July 2014 - Volume 93 - Issue 7 - p 562–569
doi: 10.1097/PHM.0000000000000062
Original Research Articles

Objective: The aim of this study was to determine the association between functional recovery and neuropsychiatric symptoms in hip fracture patients undergoing in-hospital rehabilitation. Very few studies have extensively evaluated neuropsychiatric symptoms in hip fracture patients, and the relationship between these symptoms and rehabilitation outcome is not yet clearly defined.

Design: This study was conducted on 200 patients with hip fracture who underwent a rehabilitation program. The Neuropsychiatric Inventory was used to identify neuropsychiatric symptoms. Efficiency and effectiveness in terms of the motor–Functional Independence Measure and length of stay were considered as outcome measures.

Results: At admission, 74% of the patients had neuropsychiatric symptoms. At the end of rehabilitation, the patients with neuropsychiatric symptoms had a lower motor–Functional Independence Measure effectiveness (P = 0.015) and efficiency (P = 0.002) and a longer length of stay (P = 0.008) than those without neuropsychiatric symptoms. However, after adjustment for the Mini-Mental State Examination, the patients with neuropsychiatric symptoms differed from those without symptoms only in terms of longer length of stay (P = 0.006) and lower motor–Functional Independence Measure efficiency (P = 0.008).

Conclusions: Neuropsychiatric symptoms make the rehabilitation process slower and less efficient in hip fracture patients. Understanding the relationship between neuropsychiatric symptoms and outcome may be useful to physicians for the management of hip fracture patients.

From the Unit of Recovery and Functional Rehabilitation, Scientific Institute of Lumezzane, Fondazione Salvatore Maugeri, IRCCS, Lumezzane, Brescia, Italy.

All correspondence and requests for reprints should be addressed to Bernardo Gialanella, MD, Unit Operativa di Recupero e Rieducazione Funzionale, Fondazione Salvatore Maugeri, IRCCS, Via G Mazzini, 129-25065, Lumezzane (BS), Italy.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2014 by Lippincott Williams & Wilkins