Abstract
Health-related quality of life (HRQOL) represents a central outcome following hip fracture surgery. This study examined whether psychological resilience and other factors predict HRQOL. In this prospective longitudinal study, patients ≥60 years undergoing hip fracture surgery in southern Taiwan were consecutively recruited. HRQOL was measured by the 36-item Short Form Health Survey (SF-36) and psychological resilience by the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). Both tools were administered at admission prefracture (at admission, based on recall), and at 6 and 12 weeks postoperatively. Changes and predictors of HRQOL within 12 weeks were analyzed using generalized estimating equations. Generalized estimating equations were used to analyze changes in these and predictors of HRQOL within 12 weeks after surgery. Among 50 participants (mean age 72.1 ± 9.6 years; 58% female), psychological resilience (CD-RISC-10) showed no significant changes across baseline, 6 weeks, and 12 weeks postoperatively, whereas HRQOL (SF-36 total, physical, and mental health domains) declined at 6 weeks but returned to baseline by 12 weeks (SF-36: b = -9.19, P < .001; physical health domain: b = -5.29, P < .001; mental health domain: b = -3.90, P = .001). Higher prefracture CD-RISC-10 scores significantly predicted better SF-36 total, physical, and mental health domains (all P < .001), whereas a hospital stay ≥8 days was associated with lower SF-36 and its mental health domain. In conclusion, psychological resilience supports postoperative HRQOL, underscoring its relevance as a perioperative care target. Larger, long-term studies are warranted to confirm these effects and elucidate their sustained impact.