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This study will examine whether a home-based rehabilitation program can help older adults recover after surgery for a hip fracture. The program is delivered by a specialized "Hospital-at-Home" unit, which provides hospital-level care in the patient's home.
Participants in this study are adults aged 65 years and older who have undergone hip fracture surgery at Hospital Universitari i Politècnic La Fe in Valencia, Spain. Instead of remaining in the hospital after surgery, participants will be admitted to the Hospital-at-Home program. A multidisciplinary medical team will provide comprehensive care at home, including medication management, wound care, and in-home physical therapy.
The primary goal of the study is to assess recovery of walking ability and mobility within the home. The study will also evaluate overall functional improvement, frailty, and survival. Participants will be assessed at the start of the program and again at 45 days and 180 days after surgery.
The information collected will help determine whether this type of home-based care is an effective option for supporting recovery and independence in older adults after a hip fracture.
Recruitment for the study began in February 2024 and is expected to continue for one year.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Home rehabilitation of hip fracture | The cohort included patients with hip fracture who were referred from the hospital to home-based rehabilitation at discharge, managed by a multidisciplinary team that included physiotherapists. |
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| Measure | Description | Time Frame |
|---|---|---|
| Walking ability and home transfers | Walking ability and home transfers, taken from the Barthel Index | assessed at different time points (prior, admission to the UHD, and at 45 and 180 days). |
| Measure | Description | Time Frame |
|---|---|---|
| Functional improvement | measured by the change of the Barthel Index | prior, admission to the UHD, and at 45 and 180 days |
| Mortality | Number of deaths |
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Inclusion Criteria:
Exclusion Criteria:
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Older undergoing surgery for traumatic hip fracture.
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| Name | Affiliation | Role |
|---|---|---|
| Ana Torrego, MD, PhD | Hospital at Home Unit - Hospital UiP La Fe Valencia Avda Fernando Abril Martorell 106 Torre B Planta 1 Valencia 26206 (SPAIN) | Principal Investigator |
| Ana Soler, MD, PhD | Physical Medicine and Rehabilitation Service (SMFR); Hospital UiP La Fe Valencia Avda Fernando Abril Martorell 106 | Study Chair |
| Elisa Soriano, MD, PhD | Hospital at Home Unit Hospital UiP La Fe Valencia Avda Fernando Abril Martorell 106 Torre B Planta 1 Valencia 26206 (SPAIN) | Study Chair |
| Marta Muñoz Domingo, Senior Technician / Research C | Universitat Politècnica de València (UPV) Centro de Investigación de Ingeniería Económica (CIEGS) | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital Universitari i Politècnic La Fe | Valencia | Valencia | 46026 | Spain |
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| ID | Term |
|---|---|
| D006620 | Hip Fractures |
| ID | Term |
|---|---|
| D005264 | Femoral Fractures |
| D050723 | Fractures, Bone |
| D014947 | Wounds and Injuries |
| D025981 | Hip Injuries |
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| 360 days |
| Frailty was assessed with the Rockwood Index at the time of admission, at baseline | The modified Clinical Frailty Scale (CFS) is a simple, 34-point clinical tool used by healthcare providers to quickly summarize a patient's overall level of fitness or frailty based on their mobility, energy, and function. It helps predict outcomes and guide care decisions in older adults. | Baseline |
| Number of participants with all-cause readmission, delirium, wound infection, or bleeding | Safety was assessed by monitoring the occurrence of all-cause readmissions, episodes of delirium, wound infection, or bleeding during the intervention period. | 15 days |
| Change in quality of life assessed by the EuroQoL-5D questionnaire | Quality of life was assessed using the EuroQol-5D-3L (EQ-5D-3L), a standardized instrument measuring health-related quality of life across five dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), each with three levels. The descriptive system defines health states and does not itself yield a single score with fixed minimum and maximum values. Health states can be converted into a utility index typically ranging from values below 0 (worse than death) to 1 (full health), where higher scores indicate better health. Changes in quality of life will be assessed at 12 months | One year |
| D007869 |
| Leg Injuries |