Introduction

The current understanding of prognostic factors of functional recovery after a proximal femoral fracture is limited, and enhancements could improve the prognostic accuracy and target subgroups for additional care strategies. This systematic review aims to identify all studied factors with an independent prognostic value for the long-term functional recovery of patients with a proximal femoral fracture.

Materials and methods

Observational studies with multivariate analyses on prognostic factors of long-term functional outcome after proximal femoral fractures were obtained through an electronic search performed on November 9, 2018.

Results

In the 31 included articles, thirteen prognostic factors were studied by at least two independent studies and an additional ten by only one study. Age, comorbidity, functionality and cognition were factors for which the majority of studies indicated a significant effect. The majority of studies which included sex as a factor found no significant effect. The level of evidence for the remaining factors was deemed too low to be conclusive on their relevance for long-term functional outcome.

Conclusion

The identified factors showed overlap with prognostic factors of short-term functional outcomes and mortality. The validity and applicability of prognostic models based on these factors may be of interest for future research.

中文翻译：

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与股骨近端骨折患者长期功能预后相关的独立因素：系统评价。

介绍

目前对股骨近端骨折后功能恢复的预后因素的了解是有限的，增强可以改善预后的准确性，并为其他护理策略提供目标亚组。本系统综述旨在确定所有具有独立预后价值的研究因素，以评估股骨近端骨折患者的长期功能。

材料和方法

通过2018年11月9日进行的电子搜索获得了对股骨近端骨折后长期功能预后的多因素分析的观察性研究。

结果

在包括在内的31篇文章中，至少两项独立研究对13种预后因素进行了研究，仅一项研究对另外10种预后因素进行了研究。年龄，合并症，功能和认知是大多数研究表明有显著作用的因素。多数将性别作为因素的研究均未发现明显影响。其余因素的证据水平被认为太低，无法确定其与长期功能结局的相关性。

结论

确定的因素与短期功能预后和死亡率的预后因素重叠。基于这些因素的预后模型的有效性和适用性可能对未来的研究感兴趣。