Surgery-related factors associated with early postoperative kinesiophobia in geriatric hip fracture patients: a risk stratification model

Objective To explore the current situation and surgery-related influencing factors of kinesiophobia in geriatric hip fracture (GHF) patients in the early postoperative period. Methods This study included 209 elderly hip fracture patients who underwent surgical treatment between March 2023 and March 2025. Kinesiophobia was assessed using the Tampa Scale for Kinesiophobia (TSK), while pain levels were measured using the Visual Analogue Scale (VAS). The Harris Hip Score (HHS) was used to evaluate hip function. Operative time and estimated blood loss were recorded from surgical records. Logistic regression analysis was performed to identify factors influencing kinesiophobia, and a risk model was constructed and evaluated. Results The incidence of kinesiophobia was 34.0%. Multivariate logistic regression analysis identified operative time (per 10 min increase: OR = 1.75, 95% CI: 1.32–2.31), estimated blood loss (per 10 mL increase: OR = 1.18, 95% CI: 1.09–1.29), VAS score (OR = 3.57, 95% CI: 2.01–6.33), HHS score (OR = 0.83, 95% CI: 0.75–0.91), and age (OR = 1.14, 95% CI: 1.05–1.25) as independent factors associated with kinesiophobia. The risk model demonstrated good discriminatory ability with an AUC of 0.89 (95% CI: 0.85–0.94) and satisfactory calibration (Hosmer-Lemeshow test P = 0.836). Conclusion Kinesiophobia in GHF patients at the early postoperative stage is closely related to surgical invasiveness (operative time and blood loss), pain, advanced age, and poor hip joint function. The risk model constructed based on these concurrently assessed factors may aid in the early identification of patients with high levels of early postoperative fear and inform early monitoring strategies. However, given the cross-sectional, single-time-point design of this study, longitudinal studies are needed to determine whether this early fear persists and affects long-term functional recovery.