Thirty-Day Functional Ambulation After Hip Fracture Surgery in Older Adults: A Single-Centre Retrospective Cohort Study

Abstract

Background: Regaining walking ability is a central patient-relevant outcome after hip fracture, but early recovery estimates are difficult to interpret when death and missing functional assessments are not reported separately. Objective: To describe 30-day functional ambulation, survival, and completeness of follow-up in older adults treated surgically for hip fracture at a single trauma centre. Methods: This retrospective cohort included 96 patients aged 65 years or older who underwent surgery for an intracapsular or extracapsular proximal femoral fracture between 1 January and 30 April 2024. Functional Ambulation Category (FAC) ≥3 at approximately 30 days was the prespecified operational outcome. Death and missing assessment were reported separately. An exploratory extreme-case analysis classified all missing survivor assessments as either FAC <3 or FAC ≥3. Results: The mean age was 85.3 years and 69/96 patients (71.9%) were women. Eight patients (8.3%; 95% CI 4.3–15.6%) died before day 30. Six of 88 survivors (6.8%) lacked a valid functional assessment, leaving 82 evaluable patients. FAC ≥3 was documented in 46/82 patients (56.1%; 95% CI 45.3–66.3%). Under the two extreme assumptions for missing assessments, the proportion with FAC ≥3 among survivors ranged from 52.3% to 59.1%. Conclusions: Just over half of evaluable patients attained level-surface ambulation without hands-on assistance by approximately 30 days. Outcome-specific denominators and explicit handling of mortality and missing assessments are essential when reporting early functional recovery after hip fracture.