Clinical impact of recovery room on post-operative walking performance in elderly patients submitted to hip surgery: a real-world analysis

Background Strategies aimed at favouring functional recovery after surgery for hip fracture may be of clinical importance. Aims To test the clinical utility of a recovery room (RR) in terms of postoperative walking performance in an elderly population submitted to hip fracture surgery. Methods Postoperative walking performance at rollator was assessed in 242 consecutive orthogeriatric patients able to follow the institutional physiotherapy protocol starting on day 1 after hip surgery. Group 1 (n = 186, age 86.0 +/- 9.3 years, 24.7% male) was admitted to the RR for postoperative monitoring, whereas Group 2 (n = 56, age 85.2 +/- 5.7 years, 23.2% male) was directly admitted to the ward. The best performance observed during the first three postoperative days was considered. Results Group 1 showed a better walking performance than Group 2, with a 50% lower probability of walking < 5 m (relative risk 0.51, p = 0.0005) and a two-fold higher probability of walking > 10 m (relative risk 2.10, p = 0.0005). Multivariable analysis confirmed a favourable independent effect of the RR stay on walking performance (beta = 0.205, p = 0.005). Discussion Admission to the RR in elderly patients submitted to hip fracture surgery could have an independent beneficial effect on postoperative walking functional recovery. This beneficial effect could probably depend on the possibility of ensuring a more rapid management of postoperative issues Conclusions These findings support the clinical utility of a RR implementation in facilities where hip surgery in elderly subjects is routinely performed.