{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T10:46:15Z","timestamp":1785581175462,"version":"3.56.0"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T00:00:00Z","timestamp":1647302400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T00:00:00Z","timestamp":1647302400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000774","name":"The University of Newcastle","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000774","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Trauma Emerg Surg"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>We hypothesized that unrestricted or full weight-bearing (FWB) in hip fracture would increase the opportunity to mobilize on post-operative day 1 (POD1mob) and be associated with better outcomes compared with restricted weight-bearing (RWB).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Over 4\u00a0years, 1514 geriatric hip fracture patients aged 65 and above were prospectively recruited. Outcomes were compared between FWB and RWB patients. The primary outcome was 30-day mortality. Secondary outcomes were immobility-related adverse events, length of stay (LOS), and reoperation for failure. Causal effect modelling and multivariate regression with mediation analyses were performed to examine the relation between weight-bearing status (WBS), POD1mob, and known mortality predictors.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>FWB was allowed in 1421 (96%) of 1479 surgically treated patients and RWB enforced in 58 (4%) patients. Mortality within 30 days occurred in 141 (9.9%) of FWB and 3 (5.2%) of RWB patients. In adjusted analysis, RWB did not influence 30-day mortality (OR 0.42, 95% CI 0.15\u201301.13, <jats:italic>p<\/jats:italic>\u2009=\u20090.293), with the WBS accounting for 91% of the total effect on mortality and 9% contributed from how WBS influenced the POD1mob. RWB was significantly related to increased DVT (OR 7.81, 95% CI: 1.81\u201333.71 <jats:italic>p<\/jats:italic>\u2009=\u20090.002) but no other secondary outcomes. Patients that did not have the opportunity to mobilize had increased 30-day mortality (OR 2.31, 95% CI 1.53\u20133.48 <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Restricted weight-bearing was not associated with increased 30-day mortality. Only a small proportion of this effect was mediated by POD1mob. Whilst post-surgical WBS may be difficult to influence for cultural reasons, POD1mob is an easily modifiable target that is likely to have a greater effect on 30-day mortality.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Level of evidence<\/jats:title>\n                <jats:p>Level III, observational study.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00068-022-01939-6","type":"journal-article","created":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T09:02:40Z","timestamp":1647334960000},"page":"4093-4103","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["The influence of weight-bearing status on post-operative mobility and outcomes in geriatric hip fracture"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1404-9983","authenticated-orcid":false,"given":"Seth Michael","family":"Tarrant","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9800-1308","authenticated-orcid":false,"given":"John","family":"Attia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0277-4822","authenticated-orcid":false,"given":"Zsolt Janos","family":"Balogh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,3,15]]},"reference":[{"issue":"4","key":"1939_CR1","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.1007\/s00268-019-05237-y","volume":"44","author":"SM Tarrant","year":"2020","unstructured":"Tarrant SM, Balogh ZJ. The global burden of surgical management of osteoporotic fractures. World J Surg. 2020;44(4):1009\u201319.","journal-title":"World J Surg"},{"key":"1939_CR2","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1007\/978-3-030-48126-1_19","volume-title":"Orthogeriatrics: the management of older patients with fragility fractures","author":"C Ojeda-Thies","year":"2021","unstructured":"Ojeda-Thies C, et al. Fragility fracture audit. In: Falaschi P, Marsh D, editors., et al., Orthogeriatrics: the management of older patients with fragility fractures. Cham: Springer; 2021. p. 331\u201357."},{"key":"1939_CR3","first-page":"CD001704","volume":"3","author":"HH Handoll","year":"2011","unstructured":"Handoll HH, Sherrington C, Mak JC. Interventions for improving mobility after hip fracture surgery in adults. Cochrane Database Syst Rev. 2011;3:CD001704.","journal-title":"Cochrane Database Syst Rev"},{"key":"1939_CR4","unstructured":"Australian and New Zealand Hip Fracture Registry. ANZHFR bi-national annual report of hip fracture care. 2018. 2018: Sydney, Australia"},{"issue":"10","key":"1939_CR5","doi-asserted-by":"publisher","first-page":"1377","DOI":"10.1302\/0301-620X.100B10.BJJ-2018-0489.R1","volume":"100-B","author":"TD Ottesen","year":"2018","unstructured":"Ottesen TD, et al. Increased complications in geriatric patients with a fracture of the hip whose postoperative weight-bearing is restricted. Bone Jt J. 2018;100-B(10):1377\u201384.","journal-title":"Bone Jt J"},{"issue":"1","key":"1939_CR6","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1111\/j.1365-2753.2008.00943.x","volume":"15","author":"J Wu","year":"2009","unstructured":"Wu J, Kurrle S, Cameron ID. Restricted weight bearing after hip fracture surgery in the elderly: economic costs and health outcomes. J Eval Clin Pract. 2009;15(1):217\u20139.","journal-title":"J Eval Clin Pract"},{"key":"1939_CR7","unstructured":"Australia and New Zealand Hip Fracture Registry. Data dictionary. 2013; Sydney, Australia"},{"issue":"11","key":"1939_CR8","doi-asserted-by":"publisher","first-page":"936","DOI":"10.2106\/JBJS.17.01222","volume":"100","author":"C Kammerlander","year":"2018","unstructured":"Kammerlander C, et al. Inability of older adult patients with hip fracture to maintain postoperative weight-bearing restrictions. J Bone Jt Surg Am. 2018;100(11):936\u201341.","journal-title":"J Bone Jt Surg Am"},{"issue":"Suppl 1","key":"1939_CR9","first-page":"S1","volume":"32","author":"JF Kellam","year":"2018","unstructured":"Kellam JF, et al. Introduction: fracture and dislocation classification compendium-2018: International Comprehensive Classification of Fractures and Dislocations Committee. J Orthop Trauma. 2018;32(Suppl 1):S1\u201310.","journal-title":"J Orthop Trauma"},{"issue":"1","key":"1939_CR10","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1111\/tri.12895","volume":"30","author":"G Heinze","year":"2017","unstructured":"Heinze G, Dunkler D. Five myths about variable selection. Transpl Int. 2017;30(1):6\u201310.","journal-title":"Transpl Int"},{"issue":"1\u20132","key":"1939_CR11","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1007\/s11657-013-0150-3","volume":"8","author":"N Williams","year":"2013","unstructured":"Williams N, et al. Changes in hip fracture incidence, mortality and length of stay over the last decade in an Australian major trauma centre. Arch Osteoporos. 2013;8(1\u20132):150.","journal-title":"Arch Osteoporos"},{"key":"1939_CR12","doi-asserted-by":"publisher","first-page":"215145931983748","DOI":"10.1177\/2151459319837481","volume":"10","author":"AT Malik","year":"2019","unstructured":"Malik AT, et al. Factors associated with inability to bear weight following hip fracture surgery: an analysis of the ACS-NSQIP hip fracture procedure targeted database. Geriatr Orthop Surg Rehabil. 2019;10:2151459319837481.","journal-title":"Geriatr Orthop Surg Rehabil"},{"key":"1939_CR13","volume-title":"Norwegian hip fracture register","author":"Norwegian National Advisory Unit on Arthroplasty and Hip Fractures","year":"2020","unstructured":"Norwegian National Advisory Unit on Arthroplasty and Hip Fractures. Norwegian hip fracture register. Norway: Haukeland University Hospital; 2020."},{"key":"1939_CR14","unstructured":"Scottish Government. Scottish standards of care for hip fracture patients 2020. 2020; Scotland"},{"key":"1939_CR15","unstructured":"National Office of Clinical Audit. Irish hip fracture database national report 2019. 2020; Dublin, Ireland"},{"key":"1939_CR16","unstructured":"Kaiser Permanente. Kaiser permanente national implant registries: annual report 2019"},{"key":"1939_CR17","unstructured":"Dutch Institute for Clinical Audit. Impact report 2019. 2020, Netherlands"},{"key":"1939_CR18","unstructured":"Riksh\u00f6ft. \u00c5RSRAPPORT 2017. 2018; Sweden"},{"key":"1939_CR19","unstructured":"Royal College of Physicians. National hip fracture database annual report 2019. 2019; London"},{"key":"1939_CR20","unstructured":"Akademie der Unfallchirurgie GmbH. Sektion Alterstraumatologie der Deutschen Gesellschaft f\u00fcr Unfallchirurgie: Jahresbericht 2020. 2020; Cologne, Germany"},{"issue":"1","key":"1939_CR21","doi-asserted-by":"publisher","first-page":"e050","DOI":"10.1097\/OI9.0000000000000050","volume":"3","author":"TJS Chesser","year":"2020","unstructured":"Chesser TJS, et al. Hip fracture systems\u2014European experience. OTA International. 2020;3(1):e050.","journal-title":"OTA International"},{"issue":"10078","key":"1939_CR22","doi-asserted-by":"publisher","first-page":"1519","DOI":"10.1016\/S0140-6736(17)30066-1","volume":"389","author":"Fixation Using Alternative Implants for the Treatment of Hip Fractures, I.","year":"2017","unstructured":"Fixation Using Alternative Implants for the Treatment of Hip Fractures, I. Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial. Lancet. 2017;389(10078):1519\u201327.","journal-title":"Lancet"},{"issue":"12","key":"1939_CR23","doi-asserted-by":"publisher","first-page":"2743","DOI":"10.1016\/j.injury.2016.10.022","volume":"47","author":"HK Song","year":"2016","unstructured":"Song HK, Choi HJ, Yang KH. Risk factors of avascular necrosis of the femoral head and fixation failure in patients with valgus angulated femoral neck fractures over the age of 50 years. Injury. 2016;47(12):2743\u20138.","journal-title":"Injury"},{"issue":"Suppl 3","key":"1939_CR24","doi-asserted-by":"publisher","first-page":"S9","DOI":"10.1097\/BOT.0000000000001940","volume":"34","author":"S Afaq","year":"2020","unstructured":"Afaq S, et al. Arthroplasty versus internal fixation for the treatment of undisplaced femoral neck fractures: a retrospective cohort study. J Orthop Trauma. 2020;34(Suppl 3):S9\u201314.","journal-title":"J Orthop Trauma"},{"issue":"1","key":"1939_CR25","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1111\/jep.12645","volume":"24","author":"L Carlin","year":"2018","unstructured":"Carlin L, et al. Exploring Canadian surgeons\u2019 decisions about postoperative weight bearing for their hip fracture patients. J Eval Clin Pract. 2018;24(1):42\u20137.","journal-title":"J Eval Clin Pract"},{"key":"1939_CR26","unstructured":"Australian Commission on Safety and Quality in Health Care. Hip fracture care clinical care standard. ACSQHC, Editor. 2016; Sydney, Australia"},{"key":"1939_CR27","unstructured":"NICE (National Institute for Health and Care Excellence). Hip fracture: management. 2017; London, UK"},{"issue":"6","key":"1939_CR28","doi-asserted-by":"publisher","first-page":"1243","DOI":"10.1007\/s00198-019-04939-2","volume":"30","author":"C Ojeda-Thies","year":"2019","unstructured":"Ojeda-Thies C, et al. Spanish national hip fracture registry (RNFC): analysis of its first annual report and international comparison with other established registries. Osteoporos Int. 2019;30(6):1243\u201354.","journal-title":"Osteoporos Int"},{"issue":"7","key":"1939_CR29","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1111\/j.1445-2197.2006.03786.x","volume":"76","author":"LB Oldmeadow","year":"2006","unstructured":"Oldmeadow LB, et al. No rest for the wounded: early ambulation after hip surgery accelerates recovery. ANZ J Surg. 2006;76(7):607\u201311.","journal-title":"ANZ J Surg"},{"issue":"11","key":"1939_CR30","doi-asserted-by":"publisher","first-page":"1042","DOI":"10.1093\/gerona\/58.11.M1042","volume":"58","author":"HK Kamel","year":"2003","unstructured":"Kamel HK, et al. Time to ambulation after hip fracture surgery: relation to hospitalization outcomes. J Gerontol A Biol Sci Med Sci. 2003;58(11):1042\u20135.","journal-title":"J Gerontol A Biol Sci Med Sci"},{"issue":"4","key":"1939_CR31","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1007\/s41999-020-00317-y","volume":"11","author":"H Ferris","year":"2020","unstructured":"Ferris H, Brent L, Coughlan T. Early mobilisation reduces the risk of in-hospital mortality following hip fracture. Eur Geriatr Med. 2020;11(4):527\u201333.","journal-title":"Eur Geriatr Med"},{"issue":"7","key":"1939_CR32","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1001\/archinte.166.7.766","volume":"166","author":"AL Siu","year":"2006","unstructured":"Siu AL, et al. Early ambulation after hip fracture: effects on function and mortality. Arch Intern Med. 2006;166(7):766\u201371.","journal-title":"Arch Intern Med"},{"key":"1939_CR33","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1093\/ageing\/afaa204","volume":"50","author":"KJ Sheehan","year":"2020","unstructured":"Sheehan KJ, et al. Discharge after hip fracture surgery by mobilisation timing: secondary analysis of the UK national hip fracture database. Age Ageing. 2020;50:415\u201322.","journal-title":"Age Ageing"},{"issue":"5","key":"1939_CR34","doi-asserted-by":"publisher","first-page":"e238","DOI":"10.5435\/JAAOS-D-20-00554","volume":"29","author":"JJ Heiden","year":"2021","unstructured":"Heiden JJ, et al. Early ambulation after hip fracture surgery is associated with decreased 30-day mortality. J Am Acad Orthop Surg. 2021;29(5):e238\u201342.","journal-title":"J Am Acad Orthop Surg"},{"issue":"1","key":"1939_CR35","doi-asserted-by":"publisher","first-page":"e005406","DOI":"10.1136\/bmjopen-2014-005406","volume":"5","author":"F Griffiths","year":"2015","unstructured":"Griffiths F, et al. Evaluating recovery following hip fracture: a qualitative interview study of what is important to patients. BMJ Open. 2015;5(1):e005406.","journal-title":"BMJ Open"},{"issue":"1","key":"1939_CR36","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1007\/s11657-019-0576-3","volume":"14","author":"SC Voeten","year":"2019","unstructured":"Voeten SC, et al. The Dutch hip fracture audit: evaluation of the quality of multidisciplinary hip fracture care in the Netherlands. Arch Osteoporos. 2019;14(1):28.","journal-title":"Arch Osteoporos"},{"key":"1939_CR37","doi-asserted-by":"publisher","first-page":"894","DOI":"10.1016\/j.injury.2020.10.079","volume":"52","author":"LC Maling","year":"2020","unstructured":"Maling LC, et al. The National hip fracture database is only as good as the data we feed it\u2014significant inaccuracy demonstrated and how to improve it. Injury. 2020;52:894\u20137.","journal-title":"Injury"},{"issue":"3","key":"1939_CR38","doi-asserted-by":"publisher","first-page":"000490","DOI":"10.1136\/bmjoq-2018-000490","volume":"8","author":"AC Tan","year":"2019","unstructured":"Tan AC, et al. Data quality audit of a clinical quality registry: a generic framework and case study of the Australian and New Zealand Hip Fracture Registry. BMJ Open Qual. 2019;8(3):000490.","journal-title":"BMJ Open Qual"},{"issue":"3","key":"1939_CR39","doi-asserted-by":"publisher","first-page":"e135","DOI":"10.5435\/JAAOS-D-17-00696","volume":"27","author":"T Shelton","year":"2019","unstructured":"Shelton T, et al. A comparison of geriatric hip fracture databases. J Am Acad Orthop Surg. 2019;27(3):e135\u201341.","journal-title":"J Am Acad Orthop Surg"},{"issue":"10","key":"1939_CR40","doi-asserted-by":"publisher","first-page":"2174","DOI":"10.1016\/j.injury.2017.08.001","volume":"48","author":"A Johansen","year":"2017","unstructured":"Johansen A, et al. Using national hip fracture registries and audit databases to develop an international perspective. Injury. 2017;48(10):2174\u20139.","journal-title":"Injury"}],"container-title":["European Journal of Trauma and Emergency Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-022-01939-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00068-022-01939-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-022-01939-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T18:11:34Z","timestamp":1664907094000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00068-022-01939-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,15]]},"references-count":40,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["1939"],"URL":"https:\/\/doi.org\/10.1007\/s00068-022-01939-6","relation":{},"ISSN":["1863-9933","1863-9941"],"issn-type":[{"value":"1863-9933","type":"print"},{"value":"1863-9941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,15]]},"assertion":[{"value":"24 August 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 February 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 March 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no conflicts of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Code availability"}},{"value":"Approval for prospective data collection by local ethics governance (HREC\/14\/CIPHS\/51).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval (include appropriate approvals or waivers)"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"All data are deidentified for publication purposes.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}