Author Interviews, Hip Fractures, JAMA, Orthopedics / 31.01.2020 Interview with: Alison MCoganPhDOTR/L Polytrauma/TBI Advanced Fellow Washington DC VA Medical Center Washington DC What is the background for this study? Response: Medicare is shifting from a volume- to value-based payment for postacute care services, in which value is determined by patient characteristics and functional outcomes. Matching therapy time and length of stay (LOS) to patient needs is critical to optimize functional outcomes and manage costs. The objective of this study was to investigate the association among therapy time, LOS, and functional outcomes for patients following hip fracture surgery. This retrospective cohort study analyzed data on patients from 4 inpatient rehabilitation facilities and 7 skilled nursing facilities in the eastern and midwestern United States. Participants were patients aged 65 years or older who received inpatient rehabilitation services for hip fracture and had Medicare fee-for-service as their primary payer. We categorized patients into nine recovery groups based on low, medium, and high therapy minutes per day and low, medium, or high rate of functional gain per day. We measured the groups for functional mobility independence and self-care capabilities at the time each patient was discharged. (more…)
Author Interviews, Geriatrics, Hip Fractures, JAMA, Orthopedics, Osteoporosis / 17.06.2019 Interview with: Kristine E. Ensrud MD MPH Professor of Medicine and Epidemiology and Community Health University of Minnesota Core Investigator, Center for Care Delivery and Outcomes Research Minneapolis VA Health Care System What is the background for this study? Response: Women aged 80 years and older, a rapidly growing segment of the population, account for the majority of hip fractures in the United States. Hip fractures account for 72% of fracture-related health care expenditures and lead to significant morbidity and mortality. However, many late-life women at high risk of hip fracture are undiagnosed. Clinicians have difficulty identifying late-life women most likely to benefit from osteoporosis screening and interventions to prevent hip fracture in part due to concerns about comorbidity burden and prognosis in this patient population. (more…)
Anesthesiology, Author Interviews, JAMA, Surgical Research / 25.02.2019 Interview with: Bheeshma Ravi, MD, PhD, FRCSC Scientist Sunnybrook Health Sciences Centre Holland Centre Toronto, ON What is the background for this study? What are the main findings? Response: Delirium is an acute change in mental status characterized by fluctuating disturbances of consciousness and attention. Elderly patients are prone to delirium after surgery; this contributes significantly to post-operative morbidity and can also lead to long-term disability. Our study found that among older adults undergoing hip fracture surgery, both an increased duration of surgery and a general anesthetic are associated with an increased risk for post-operative delirium.​  (more…)
Hip Fractures / 29.10.2013 Interview with: Stefano Volpato MD MPH Department of Medical Sciences, University of Ferrara Ferrara, Italy What are the main findings of the study? Dr. Volpato: In this study we evaluated clinical value of handgrip strength  assessment in older patients admitted to the hospital for hip fracture. We observed 504 older patients admitted to 4 Italian hospitals for hip surgery, able of walking independently before fracture, and we found a strong, graded and independent association of grip strength, assessed before hip surgery, and the likelihood of functional recovery over the one-year follow-up. The findings reported in our manuscript can be summarized as: a. handgrip strength significantly correlated with several prognostic factors traditionally considered in clinical practice, such as age, gender, neuro-psychological and functional status, comorbidity level, vitamin D plasma levels, and time before the surgical procedure; b. logistic regression models showed that handgrip strength was directly associated with higher probability of walking recovery, both at any follow-up (incident walking recovery), and for at least 2 consecutive follow-ups (persistent walking recovery); b. Kaplan-Meier survival estimates showed that lower grip strength was related to increased mortality after hip surgery; c. the association between grip performance and walking recovery was clinically relevant and statistically independent of potential confounders. (more…)
Author Interviews, Genetic Research, Hip Fractures, Weight Research / 25.09.2013

Professor Tuan V. Nguyen Osteoporosis and Bone Biology Program Garvan Institute of Medical Research 384 Victoria Street, Darlinghurst NSW 2010 Interview with: Professor Tuan V. Nguyen Osteoporosis and Bone Biology Program Garvan Institute of Medical Research 384 Victoria Street, Darlinghurst NSW 2010 Australia What are the main findings of the study? Dr. Nguyen: We analyzed polymorphisms of the FTO (fat mass and obesity) gene in 934 elderly women of Caucasian background, and found that carriers of minor genotype (AA) of the SNP rs1121980 had a two-fold increase in the risk of hip fracture compared with carriers of major genotype (GG). Approximately 20% of women are carriers of the AA genotype. We estimate that about 17% of hip fracture cases could be attributed to the variation within the gene. (more…)