Public Defence: Shams Dakhil

Cand.med. Shams Dakhil at Institute of Clinical Medicine will be defending the thesis “Functional decline after a hip fracture – Long-term trajectories and the impact of orthogeriatric care and of fracture type” for the degree of PhD (Philosophiae Doctor).

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Photo: Omar Couri

Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.

Trial Lecture – time and place

See Trial Lecture.

Adjudication committee

  • First opponent: Professor Jan Erik Gjertsen, University of Bergen
  • Second opponent: Associate Professor Merete Gregersen, AUH - Aarhus University Hospital, Denmark
  • Third member and chair of the evaluation committee: Professor II Per-Henrik Randsborg, University of Oslo

Chair of the Defence

Professor II Olav Magnus Søndenå Fredheim, University of Oslo

Principal Supervisor

Professor II Leiv Otto Watne, University of Oslo

Summary

Hip fractures are among the most common fractures in older adults, and are serious and dramatic events, often with debilitating consequences such as loss of function and increased dependency. Hip fracture patients are often frail making them susceptible to adverse outcomes, and a significant amount of these patients do not regain their pre-fracture function. This, in turn, is associated with reduced quality of life and an increase in nursing home admissions, which requires more socioeconomic and public health care services. The aim of this thesis was to investigate a heterogenous population of hip fracture patients, in order to increase our understanding of the effect of orthogeriatric care on function, functional trajectories and the differences between intracapsular and extracapsular hip fracture patients. Two previously conducted randomized controlled trials were combined into a larger dataset. Both trials were planned for future pooling of data, and hip fracture patients were randomized either to traditional orthopedic care or to a geriatric ward where they received comprehensive geriatric care.

We found that orthogeriatric care significantly improved function in hip fracture patients up to one year after surgery, and that hip fracture patients can be grouped into four trajectories of function after a hip fracture, in which no group regains their pre-fracture function. One of these groups had relatively good pre-fracture function but declined steeply in function the first four months after surgery, which is clinically interesting and should be studied further in the future. Furthermore, we found that patients with an intracapsular hip fracture had better function and mobility initially after surgery compared to patients with an extracapsular fracture. The difference did not persist after one year, indicating a faster initial recovery in these patients.

Additional information

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Published Dec. 1, 2023 10:47 AM - Last modified Dec. 13, 2023 1:29 PM