The use of Barthel index for the assessment of the functional recovery after osteoporotic hip fracture: One year follow-up

The Barthel index evolution was analyzed in a sample of older people with osteoporotic hip fracture in order to verify the influence of comorbidities and cognitive impairment on the physical recovery of those patients, during the first year following the fracture. A prospective observational study was carried out between October 1, 2012 and March 31, 2013. A sample of 247 individuals was initially selected. After a primary revision, 39 participants were excluded (clearly not meeting inclusion criteria, lack of data, or not agree to participate in the study), and finally a total of 208 participants were included in the analysis, 166 women, with an average age of 84.59 years, and 42 men, with an average age of 82.05. 54.80% of all cases were older than 85 years. The mean Barthel index value prior to fracture was 76.63, decreasing to 64.91 at one-year follow-up. Only 22.12% of patients achieved a full recovery for activities of daily living. A statistical analysis was performed by comparing Barthel index recovery depending on the values of Charlson and Pfeiffer indexes, respectively. The mean differences in Barthel index drop between the one-year follow-up and the hospital admission values were found statistical significant (p<0.01). These findings indicate that Charlson and Pfeiffer indexes clearly influence the Barthel index recovery. Low values of Charlson and Pfeiffer indexes resulted in better Barthel index recovery. In conclusion, the Barthel index is a good tool to evaluate the physical recovery after osteoporotic hip fracture.