The association between psychotropic medication use and functional outcome of elderly hip-fracture patients undergoing rehabilitation

Objective: To study the interrelations between use of psychotropic medications and functional outcomes of elderly hip fracture patients undergoing rehabilitation. Design: A retrospective parallel group study. Setting: A geriatric rehabilitation department in a large urban academic hospital. Participants: Records of 432 elderly people with extracapsular or intracapsular hip fractures were initially screened between 1999 and 2003. Of these, 263 subjects were eligible for the study. Their average age was 82.2±6.9 years. The average length of stay was 29.0±10.2 days. Interventions: Not applicable. Main Outcome Measures: Absolute (uncorrected) functional gains measured by the FIM instrument and relative (corrected) FIM gains calculated according to the Montebello equation. Results: Of the 263 patients included in the final analysis, 153 (62.4%) were treated with psychotropics. The 2 groups were similar, yet psychotropic drug users were more likely to be women (P=.028) and to suffer intracapsular fractures (P=.027). Similar improvements in absolute FIM scores were observed during rehabilitation in both groups. However, both total and motor relative functional gains were lower in psychotropic drug users (.33±0.1 vs .39±0.1, P=.021) than in nonusers (.31±0.1 vs .42±0.2, P=.039). Regression analysis showed that female sex (P=.029), higher Folstein Mini-Mental State Examination score (P<.001), and independent prefracture function (P<.01) were associated with higher motor FIM gains. Use of minor tranquillizers was only slightly-and adversely-associated with lower FIM gains (r=-2.68, P=.047), whereas the use of antidepressants and antipsychotics had no effect on these parameters. Conclusions: Use of psychotropic medications does not appear to be associated with functional outcome of elderly hip fracture patients undergoing rehabilitation.