Impact of post-hospitalization dysphagia on dependence in activities of daily living at discharge in older adults with hip fracture: A nationwide inpatient database study.

Background: Older adults with hip fractures of the femur have a higher probability of developing dysphagia after surgery. Dysphagia affects older patients with hip fractures in multiple ways, thus clinicians need to understand the impact of dysphagia on the effectiveness of treatment.

Aims: The aim of this study is to clarify the impact of dysphagia on dependence in activities of daily living in older adults with hip fractures.

Methods: This retrospective observational study utilized a nationwide inpatient database, encompassing acute inpatient care from 2017 to 2022. Older adults (≥60 years) with hip fractures who underwent surgery and survived to discharge were included. Dysphagia was analyzed as a factor affecting dependence in activities of daily living at discharge using binomial logistic regression and the inverse probability of treatment weighting (IPTW) method, which was based on propensity scores.

Results: The analysis included 88,809 older adults with hip fractures. Binomial logistic regression analysis showed that dysphagia was significantly associated with dependence in activities of daily living, with an odds ratio of 3.24 (95 % confidence interval [CI], 2.72-3.85; p < 0.01). Furthermore, sensitivity analysis confirmed these findings. After adjusting for IPTW, dysphagia remained a significant factor for dependence in activities of daily living at discharge, with an odds ratio of 2.55 (95 % CI, 2.45-2.64; p < 0.01).

Conclusions: In older adults with hip fractures, dysphagia negatively affects the activities of daily living at discharge. These results are useful for clinicians for understanding the significance of preventing dysphagia development.