Functional outcomes in the aged with hip fracture: A systematic review of randomized clinical trials

Hip fracture trials have used a wide range of patient-reported outcomes (PRO) suggesting a lack of consensus among clinicians on what are considered the most relevant functional outcomes. We conducted a systematic review to identify the outcomes used in hip fracture randomized controlled trials (RCTs). We hypothesized that there had been an increase in numbers of PROs over time and the health status measure, SF-36, would be used the most. A database search and screening yielded 86 original trials. The mean Detsky score (and standard error) for quality was: 75.8% ± 1.76%. There was a trend in the increase of functional outcome; however, the SF-36 was used only in (10 out of 86) 11.6% trials. Both the ADL-Katz Index and HHS have lower respondent burden than the SF36 which may contribute to their frequent use in hip RCTs. There is a lack of applicable measures suitable for patients with dementia.