Early Mobilization Compliance as a Quality Indicator After Hip Fracture Surgery: An Observational Study

Abstract

Background: Hip fracture represents a major public health challenge in aging populations and is associated with high morbidity, functional decline, and increased healthcare utilization. Early mobilization within the first 24 h after surgery is considered a key quality indicator in hip fracture care and has been associated with improved functional recovery and reduced postoperative complications. The aim of this study was to evaluate compliance with early mobilization and identify clinical and organizational factors associated with its implementation. Methods: A retrospective observational study was conducted in the surgical hospitalization unit of a tertiary hospital in Madrid, Spain. All adult patients who underwent hip fracture surgery between January and December 2023 were included. Sociodemographic, clinical, and functional variables were collected from electronic medical records. Early mobilization within the first 24 h after surgery was defined as the primary outcome and analyzed in relation to clinical and organizational variables. Results: A total of 139 patients were included, with a mean age of 82.4 ± 11.3 years, and 79.1% were women. Early mobilization was achieved in 66.2% of patients. Significant associations were observed between early mobilization and blood transfusion requirements (p = 0.002), postoperative radiography performed within the first 24 h (p = 0.004), and the presence of an explicit medical order for mobilization (p < 0.001). No significant associations were identified with age, sex, functional dependency, cognitive impairment, baseline mobility, or ASA classification. Conclusions: Early mobilization after hip fracture surgery was associated with several modifiable clinical and organizational factors in this cohort. However, these findings should be interpreted with caution because fracture-specific and surgery-specific variables were not available. Implementing standardized protocols, automatic mobilization orders, and optimized perioperative management strategies may improve compliance with this key quality indicator and enhance postoperative recovery.