{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T22:38:28Z","timestamp":1793831908988,"version":"4.6.1"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the group heterogeneity in postoperative intrinsic capacity (IC) recovery trajectories among older hip fracture (HF) patients and identify key independently associated factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective longitudinal study of 184 older patients following HF surgery at two tertiary hospitals. IC was assessed at 48\u202fh, pre-discharge, 1\u202fmonth, and 3\u202fmonths post-surgery. A multi-state Markov model (MSM) was used to quantify transition intensity and probability between IC states, a latent class growth model (LCGM) was employed to identify heterogeneous trajectories of total IC scores, and predictors of trajectory categories were analyzed via multinomial logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>MSM revealed that patients in the \u201csevere IC impairment\u201d state had a 96.3% probability of remaining in that state throughout the 3-month follow-up. LCGM further identified three distinct recovery trajectories: the Higher-Level Growth Group (21.2%), the Medium-Level Improvement Group (36.9%), and the Lower-Level Stability Group (41.8%). Multivariate analysis indicated that age 60\u201369\u202fyears was significantly associated with increased odds of belonging to the Medium-Level Improvement Group (OR\u202f=\u202f18.12, 95% CI: 4.22\u201377.86) and the Higher-Level Growth Group (OR\u202f=\u202f3.33, 95% CI: 1.10\u201310.09) compared to the Lower-Level Stability Group. Normal plasma albumin was significantly associated with increased odds of belonging to the Medium-Level Improvement Group (OR\u202f=\u202f7.07, 95% CI: 1.30\u201338.51).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>From a public health perspective, the identification of three distinct recovery trajectories provides an evidence-based framework for population-level risk stratification. The large subgroup (41.8%) with persistent severe impairment represents a high-risk population that may require targeted resource allocation for post-acute and long-term care. These findings support the development of tiered rehabilitation strategies at the health system level, aligning with the goals of healthy aging.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1859779","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T05:37:52Z","timestamp":1783316272000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Heterogeneity in postoperative intrinsic capacity trajectories in older adults with hip fractures: a prospective longitudinal study"],"prefix":"10.3389","volume":"14","author":[{"given":"Wenya","family":"Qiang","sequence":"first","affiliation":[{"name":"Department of Nursing, Shaanxi Provincial People's Hospital","place":["Xi'an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huolan","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Shaanxi Provincial People's Hospital","place":["Xi'an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenni","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Nursing, Shaanxi Provincial People's Hospital","place":["Xi'an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xixi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Nursing, Shaanxi Provincial People's Hospital","place":["Xi'an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiawei","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Shaanxi Provincial People's Hospital","place":["Xi'an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiaohui","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Shaanxi Provincial People's Hospital","place":["Xi'an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhijun","family":"Nie","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Shaanxi Provincial People's Hospital","place":["Xi'an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Director's Office, Shaanxi Provincial People's Hospital","place":["Xi'an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1111\/anae.15291","article-title":"Guideline for the management of hip fractures 2020: guideline by the Association of 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