Functional Predictors for Home Discharge after Hip Fracture in Patients Living in Sloped Neighborhoods or Islands: An 8-Year Retrospective Cohort Study

Round 1

Reviewer 1 Report

Thank you for the opportunity to review this paper. I really enjoyed it. I think the science is appropriate. I only have 2 comments.

Figure 1 - I could not read this all and therefore think there are formatting issues with this which need to be addressed.

There needs to be greater consideration on how the variables on slope and flat are definite and how these relate to islands. From my interpretation, this is self-reported. I need greater assurance on this that sloped is really sloped. I suspect the authors need to correlate the proximity of a gradiant change from 200 meters from the individuals habitation. It is still assuming that they walk outside but it is a stronger assumption that currently stands. I need to see either GPS or map-based assurances that sloped is sloped and flat is flat as it is currently insufficient. This is a critical issues which needs revising. 

Author Response

Dear Reviewer 1,

Thank you for inviting us to submit a revision of our manuscript.

We appreciate the time and effort that you have dedicated to providing insightful feedback on our manuscript.

Based on these suggestions, we have incorporated changes into the manuscript and now hope that this manuscript addresses all previous concerns that were noted.

The attached PDF file is a point-by-point response to your comments, and revised manuscript.

The corrections are shown using the "Track Changes" function in Microsoft Word, and highlighted in yellow lines.

Again, thank you for your kind review. We have worked hard to incorporate your feedback and hope that these revisions persuade you to accept our submission.

Sincerely,

Authors

Author Response File: Author Response.pdf

Reviewer 2 Report

This is a study evaluating the geographical and functional determinants of home discharge after hip fracture (operation). My major concern to this paper are follows:

1. The authors seem to have limited understanding of epidemiological designs. Regarding the research design, this is a typical cross-sectional study, and not a cohort study. The authors should make it clear in this paper.
2. Did all consecutive patients between December 2011 and December 2019 were recruited in this study? If yes, please state it in this paper.
3. How many times of functional measures were carried out for each patients during their hospitalization? Did the data presented in this study represents the last measure before discharging?
4. What is the common clinical criteria for discharging Patients to home or other destination? How did the doctor make their routine decisions? More descriptions are needed to this point.
5. Cognitive/physical and ADL measurement values should also be presented in Table 1.
6. It is not clear if cognitive and physical measures were adjusted for each other in the multivariate analysis. If not, such analysis is needed for a better understanding of their meaning.
7. Regarding the objective of this study, some discussion should be given about why there is no functional difference (Cognitive/physical and ADL) between the three groups of patients. Is there any recommendation to this point for future?

Author Response

Dear Reviewer 2,

Thank you for inviting us to submit a revision of our manuscript.

We appreciate the time and effort that you have dedicated to providing insightful feedback on our manuscript.

Based on these suggestions, we have incorporated changes into the manuscript and now hope that this manuscript addresses all previous concerns that were noted.

The attached PDF file is a point-by-point response to your comments and questions as delivered in your letter.

Sentences and words corrections are shown using the "Track Changes" function in Microsoft Word.

Again, thank you for your kind review. We have worked hard to incorporate your feedback and hope that these revisions persuade you to accept our submission.

Sincerely,

Authors

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Thank you for addressing the points raised earlier. I believe the authors have revised appropriately. I feel this paper is appropriate for publication.