Frequency, duration, and type of physiotherapy in the week after hip fracture surgery – analysis of implications for discharge home, readmission, survival, and recovery of mobility
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
PurposeTo examine the association between physiotherapy access after hip fracture and discharge home, readmission, survival, and mobility recovery.MethodsA 2017 Physiotherapy Hip Fracture Sprint Audit was linked to hospital records for 5383 patients. Logistic regression was used to estimate the association between physiotherapy access in the first postoperative week and discharge home, 30-day readmission post-discharge, 30-day survival and 120-days mobility recovery post-admission adjusted for age, sex, American Society of Anesthesiology grade, Hospital Frailty Risk Score and prefracture mobility/residence.ResultsOverall, 73% were female and 40% had high frailty risk. Patients who received ≥2 hours of physiotherapy (versus less) had 3% (95% Confidence Interval: 0–6%), 4% (2–6%), and 6% (1–11%) higher adjusted probabilities of discharge home, survival, and outdoor mobility recovery, and 3% (0–6%) lower adjusted probability of readmission. Recipients of exercise (versus mobilisation alone) had 6% (1–12%), 3% (0–7%), and 11% (3–18%) higher adjusted probabilities of discharge home, survival, and outdoor mobility recovery, and 6% (2–10%) lower adjusted probability of readmission. Recipients of 6–7 days physiotherapy (versus 0–2 days) had 8% (5–11%) higher adjusted probability of survival. For patients with dementia, improved probability of survival, discharge home, readmission and indoor mobility recovery were observed with greater physiotherapy access.ConclusionGreater access to physiotherapy was associated with a higher probability of positive outcomes. For every 100 patients, greater access could equate to an additional eight patients surviving to 30-days and six avoiding 30-day readmission. The findings suggest a potential benefit in terms of home discharge and outdoor mobility recovery.Contribution of the Paper•To substantiate a case for additional physiotherapy, evidence for an association with improved outcomes is needed.•Analysis of 5383 patients suggests greater access to physiotherapy was associated with higher probability of positive outcomes.•For every 100 patients, this could equate to six more patients avoiding 30-day readmission and eight more patients surviving to 30-days.•The association between access to physiotherapy and survival persisted irrespective of dementia diagnosis.•For other outcomes, associations varied by the presence/absence of dementia and should be explored by future cohort studies.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it