{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:08:55Z","timestamp":1760144935506,"version":"build-2065373602"},"reference-count":45,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T00:00:00Z","timestamp":1716940800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: Little is known about the post-operative functional outcomes of severely frail femur fracture patients, with previous studies focusing on complications and mortality. This study investigated patient- or proxy-reported outcomes after femur fracture surgery in older adult patients with severe frailty. Methods: This was a retrospective cross-sectional study of older adult (&gt;70 years) patients with severe frailty (defined by a Comprehensive Geriatric Assessment-based Frailty Index (FI-CGA) \u2265 0.40), who underwent femur fracture surgery at a Level 1 Trauma Center. Patients or their proxy (i.e., close relative) reported mobility, psychosocial, and functional outcomes at least 1-year after surgery. Results: Thirty-seven predominantly female (76%) patients with a median age of 85 years (IQR 79\u201392), and a median FI-CGA of 0.48 (IQR 0.43\u20130.54) were included. Eleven patients (30%) regained pre-fracture levels of ambulation, with twenty-six patients (70%) able to walk with or without assistance. The majority of patients (76%) were able to have meaningful conversations. Of the patients, 54% of them experienced no to minimal pain, while 8% still experienced a lot of pain. Functional independence varied, as follows: five patients (14%) could bathe themselves; nine patients (25%) could dress themselves; fourteen patients (39%) could toilet independently; and seventeen patients (47%) transferred out of a (wheel)chair independently. Conclusions: Despite the high risk of mortality and perioperative complications, many of the most severely frail patients with surgically treated femur fractures regain the ability to ambulate and live with a moderate degree of independence. This information can help healthcare providers to better inform these patients and their families of the role of surgical treatment during goals of care discussions.<\/jats:p>","DOI":"10.3390\/jcm13113197","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T06:58:07Z","timestamp":1716965887000},"page":"3197","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond Mortality: Severely Frail Femur Fracture Patients Can Regain Independence after Surgery"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9887-6909","authenticated-orcid":false,"given":"Noa H. M.","family":"Ponds","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA 02215, USA"},{"name":"Department of Surgery, St. Antonius Hospital, 3543 AZ Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1531-4857","authenticated-orcid":false,"given":"Jochem H.","family":"Raats","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA 02215, USA"},{"name":"Department of Surgery, St. Antonius Hospital, 3543 AZ Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8221-1172","authenticated-orcid":false,"given":"Devon T.","family":"Brameier","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA 02215, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7399-6828","authenticated-orcid":false,"given":"Henk Jan","family":"Schuijt","sequence":"additional","affiliation":[{"name":"Center for Geriatric Trauma, St. Antonius Hospital, 3543 AZ Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Cooper","sequence":"additional","affiliation":[{"name":"Division of Aging, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA 02215, USA"},{"name":"Department of Geriatric Medicine, Rabin Medical Center, Tel Aviv 4941492, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abigail","family":"Sagona","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA 02215, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8749-567X","authenticated-orcid":false,"given":"Houman","family":"Javedan","sequence":"additional","affiliation":[{"name":"Division of Aging, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA 02215, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Weaver","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA 02215, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1016\/S0140-6736(09)61460-4","article-title":"Ageing Populations: The Challenges Ahead","volume":"374","author":"Christensen","year":"2009","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1146\/annurev.publhealth.29.020907.090812","article-title":"Recent Declines in Chronic Disability in the Elderly U.S. Population: Risk Factors and Future Dynamics","volume":"29","author":"Manton","year":"2008","journal-title":"Proc. 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