Endocrine Abstracts

Background

Although patients with diabetes mellitus (DM) are at higher risk of hip fracture, data regarding the effect of DM on rehabilitation outcomes is limited.

Methods

A retrospective population-based study was conducted comparing diabetic and non-diabetic elderly patients with a recent hip fracture who were admitted to a geriatric rehabilitation facility during 2014–2019. The Functional Independence Measure (FIM) was used to assess physical and cognitive function. Delta-FIM was calculated by subtracting admission FIM from discharge FIM. One-year mortality, hospitalizations and fractures were assessed.

Results

Six hundred and thirty post hip-fracture elderly patients were included, mean age 83 ± 7 years, 70.48%(444) females. Of them 30.63% (193) had DM. The diabetic patients were younger (81.41 vs. 84.28 years, p value < 0.01) and had higher rates of co-morbidities including hypertension, chronic kidney disease, ischemic heart disease and cerebrovascular diseases. Baseline cognitive and motor scores were similar between groups. Delta motor-FIM was similar in diabetics and non-diabetics (15.56 ± 8.95 and 14.78 ± 8.79, respectively, P = 0.35). Similar rates of patients were discharged to nursing care facilities. on Multivariate regression analysis motor FIM improvement was positively correlated with higher BMI, male gender and younger age but not with DM. Cognitive FIM did not change significantly during rehabilitation in both groups, and there was no difference in 1-year hospitalizations or fractures rates. One-year all-cause mortality was higher in diabetic patients (10.9% and 6.6%, respectively, P = 0.07). After adjusting for covariates, DM was associated with higher mortality risk (OR = 2.78, CI[1.28, 6.04], P = 0.01).

Conclusions

Diabetic patients have similar post-hip fracture rehabilitation potential compared with non-diabetics, in spite of higher prevalence of co-morbidity. These results support resource allocation for post-hip fracture rehabilitation in patients with DM. The higher 1-year all-cause mortality in patients with DM reinforces the need for close follow-up and control of co-morbidities in this population.