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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Acute Care and Rehabilitation After Low-Trauma Hip Fractures in Older Adults—Pathways and Functional Outcomes: A Retrospective Cohort Study

  • Eva Cioffi1,2
  • Karl Müller1
  • Silviya Ivanova3
  • Albert Antoni Fava Altes1
  • Manuel Pfister4,5
  • Valerie Frischknecht1,2
  • Noora Emilia Angelva2,6
  • Thimo Marcin1
  • Matthias Wilhelm1
  • Adrian Martinez-De la Torre4,5
  • Tobias Nef6,7
  • Johannes Dominik Bastian3
1 more authors
  • Anke Scheel-Sailer1,4,8
8 affiliations
  1. 1Center for Rehabilitation & Sports Medicine, Inselspital and Berner Reha Zentrum, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
  2. 2Graduate School for Health Sciences, University of Bern, 3012 Bern, Switzerland
  3. 3Department of Orthopedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
  4. 4Faculty of Health Sciences and Medicine, University of Lucerne, 6002 Lucerne, Switzerland
  5. 5Swiss Paraplegic Research, 6207 Nottwil, Switzerland
  6. 6Gerontechnology & Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, 3010 Bern, Switzerland
  7. 7Department of Neurology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
  8. 8Centre for Rehabilitation in Global Health Systems, University of Lucerne, 6002 Lucerne, Switzerland
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Abstract

Background/Objectives: This study describes, first, healthcare pathways, including inpatient rehabilitation, and, second, functional outcomes for these low-trauma hip fracture (LTHF) types (femoral neck (FN-F), trochanteric (Tr-F), and acetabulum/periprosthetic (Ac/Pp-F) fractures). Methods: This single-center, retrospective cohort study, 2020–2023, included patients aged ≥65 years, with FN-F, Tr-F, or Ac/Pp-F, admitted to inpatient rehabilitation. Pathways comprised acute care, inpatient rehabilitation, and temporary care homes, bounded by pre-fracture situation and discharge destination. Pairwise Standardized Mean Differences (SMDs) were calculated to determine between-group differences. Results: Of 294 individuals (mean age 81.0 ± 7.4 years; 191 (65%) women; 152 Tr-F, 118 FN-F, and 24 Ac/Pp-F), four main pathways were identified: (1) acute care to inpatient rehabilitation in 208 (70.7%) individuals, (2) temporary care home stays before rehabilitation in 25 (8.5%), (3) temporary care home stays after rehabilitation in 17 (5.8%), and (4) re-hospitalization in 44 (15.0%). Median pathway length was 33.0 days (IQR 26.0–40.0) for FN-F, 35.0 (IQR 29.0–46.0) for Tr-F, and 60.5 (IQR 37.0–86.5) for Ac/Pp-F. Between-group differences in pathway type were moderate to large (SMDs: FN-F vs. Tr-F = 0.47; FN-F vs. Ac/Pp-F = 1.25; Tr-F vs. Ac/Pp-F = 0.84), and for length, small to large (SMDs: FN-F vs. Tr-F = 0.36; FN-F vs. Ac/Pp-F = 1.2; Tr-F vs. Ac/Pp-F = 0.69). Overall, 246 (83.7%) returned to a permanent private living setting. A total of 88 (29.9%) required new or increased home support or care. At discharge from rehabilitation, among participants who completed the program, the Functional Independence Measure and the Timed Up and Go test showed small-to-moderate between-group differences. Conclusions: Individuals with FN-F, Tr-F, and Ac/Pp-F fractures follow healthcare pathways in different frequencies and have different pathway durations. The findings may support the identification of future opportunities to improve continuity of healthcare, including orthogeriatric management and specialized rehabilitation.

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Cite

BibTeXRIS
BibTeX
@article{cioffi2026acute,
  title = {{Acute Care and Rehabilitation After Low-Trauma Hip Fractures in Older Adults—Pathways and Functional Outcomes: A Retrospective Cohort Study}},
  author = {Eva Cioffi and Karl Müller and Silviya Ivanova and Albert Antoni Fava Altes and Manuel Pfister and Valerie Frischknecht and Noora Emilia Angelva and Thimo Marcin and Matthias Wilhelm and Adrian Martinez-De la Torre and Tobias Nef and Johannes Dominik Bastian and Anke Scheel-Sailer},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15208074},
  url = {https://www.mdpi.com/2077-0383/15/20/8074},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Acute Care and Rehabilitation After Low-Trauma Hip Fractures in Older Adults—Pathways and Functional Outcomes: A Retrospective Cohort Study
AU  - Eva Cioffi
AU  - Karl Müller
AU  - Silviya Ivanova
AU  - Albert Antoni Fava Altes
AU  - Manuel Pfister
AU  - Valerie Frischknecht
AU  - Noora Emilia Angelva
AU  - Thimo Marcin
AU  - Matthias Wilhelm
AU  - Adrian Martinez-De la Torre
AU  - Tobias Nef
AU  - Johannes Dominik Bastian
AU  - Anke Scheel-Sailer
PY  - 2026
DA  - 2026/10/01
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15208074
UR  - https://www.mdpi.com/2077-0383/15/20/8074
AB  - Background/Objectives: This study describes, first, healthcare pathways, including inpatient rehabilitation, and, second, functional outcomes for these low-trauma hip fracture (LTHF) types (femoral neck (FN-F), trochanteric (Tr-F), and acetabulum/periprosthetic (Ac/Pp-F) fractures). Methods: This single-center, retrospective cohort study, 2020–2023, included patients aged ≥65 years, with FN-F, Tr-F, or Ac/Pp-F, admitted to inpatient rehabilitation. Pathways comprised acute care, inpatient rehabilitation, and temporary care homes, bounded by pre-fracture situation and discharge destination. Pairwise Standardized Mean Differences (SMDs) were calculated to determine between-group differences. Results: Of 294 individuals (mean age 81.0 ± 7.4 years; 191 (65%) women; 152 Tr-F, 118 FN-F, and 24 Ac/Pp-F), four main pathways were identified: (1) acute care to inpatient rehabilitation in 208 (70.7%) individuals, (2) temporary care home stays before rehabilitation in 25 (8.5%), (3) temporary care home stays after rehabilitation in 17 (5.8%), and (4) re-hospitalization in 44 (15.0%). Median pathway length was 33.0 days (IQR 26.0–40.0) for FN-F, 35.0 (IQR 29.0–46.0) for Tr-F, and 60.5 (IQR 37.0–86.5) for Ac/Pp-F. Between-group differences in pathway type were moderate to large (SMDs: FN-F vs. Tr-F = 0.47; FN-F vs. Ac/Pp-F = 1.25; Tr-F vs. Ac/Pp-F = 0.84), and for length, small to large (SMDs: FN-F vs. Tr-F = 0.36; FN-F vs. Ac/Pp-F = 1.2; Tr-F vs. Ac/Pp-F = 0.69). Overall, 246 (83.7%) returned to a permanent private living setting. A total of 88 (29.9%) required new or increased home support or care. At discharge from rehabilitation, among participants who completed the program, the Functional Independence Measure and the Timed Up and Go test showed small-to-moderate between-group differences. Conclusions: Individuals with FN-F, Tr-F, and Ac/Pp-F fractures follow healthcare pathways in different frequencies and have different pathway durations. The findings may support the identification of future opportunities to improve continuity of healthcare, including orthogeriatric management and specialized rehabilitation.
SN  - 2077-0383
ER  -