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An investigation of post-hip facture recovery and related factors in elderly persons with diabetes mellitus

Grant number: NSC98-2314-B-182-050-MY3
Source of support: National Science Council
Role on project: Principal Investigator
Duration of support: 2009/8/1-2012/7/31

Abstract:

With the increasing aging population, hip fracture represents a major and growing health care problem in Taiwan. Previous studies have found that elderly persons with diabetic mellitus (DM) have higher risk of having hip fracture. However, very few studies explored how DM and related factors influence the recovery, health outcomes, services utilization and costs following hip fracture. On the other hand, our previous studies on hip fractured elderly persons who were independent before the fracture found that those with DM had significantly lower self-perceived general health than those without DM. This suggests that patients with DM might suffer from poor recovery following hip fracture. Thus, the purpose of this study was to explore the current conditions including clinical course, self-care ability, health outcomes, caregiving outcomes, service utilization and costs of care for elderly patients with DM following hip fracture. In addition to demographic characteristics, type of fracture, cognitive functioning, co-morbidity, pre-fracture physical functioning, social support, and depressive symptoms, length of time since DM was diagnosed, serum cholesterol, serum HbA1c, albumin, hemoglobin, serum biochemistry, tendon reflexes, superficial and deep sensation, peripheral pulses, diabetic retinopathy and sign of a “diabetic foot” will be considered. To maximize potential predictors, biometrics measures including activity—daily energy consumption and arterial stiffness index will also be measured. A total of 120 hip fractured elderly persons with DM and hospitalized with hip fracture will be recruited through the emergency room and followed at before surgery, before discharge, 1st, 3rd, 6th and 12th month after discharge. Approval of Institutional Review Board (IRB) of CGMH will be obtained before the study starts. Generalized estimating equations analysis (GEE) will be used to analyze the trajectories of the outcome variables and their predictors. A 3-year period will be taken to complete this project. The preparation work will be finished during the first two months. After that, according to our previous studies, 6 hip fractured elderly persons with DM can be collected per month. Therefore, a total of 20 months will be needed to complete the subject recruitment. In addition, one year follow-up and remaining 2 months for data analysis and development of intervention protocol based on the findings will be needed. Findings of this study can contribute to the current knowledge and practice for elderly patients with DM following hip fracture.