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An Orthogeriatric Collaborative Intervention Program for Fragility Fractures: A Retrospective Cohort Study.
MedLine Citation:
PMID:  22002614     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: This retrospective cohort study aims to investigate the impact of regular pre- and postoperative geriatric input into the management of geriatric patients with hip fracture, with specific interests in morbidity and mortality. METHODS:: Patients with hip fracture (n = 548) older than 60 years were identified within a 2-year period. In the first year, the patients (n = 270) were managed mainly by orthopedics and this group constituted the control group. In the second year, this group of patients (orthogeriatric group, n = 278) had reviews by orthopedic surgeons and geriatricians (physicians specializing in medicine for the elderly), within 48 hours of admission and regularly thereafter. The main outcomes measured included demographics, length of hospital stay, postoperative complications, mortality, and functional outcomes. Data were collected from records of acute and rehabilitation admissions, and outpatient consultations. RESULTS:: The admission to operation time for those in the orthogeriatric group was shorter by 17% (p = 0.02). The percentage of patients deceased at 12 months postoperative was 11.5% for the orthogeriatric group and 20.4% for the conventional group (p = 0.02). A higher percentage of patients in the orthogeriatric group remained independent for daily living activities (24.5%) when compared with the conventional group (23.7%; p = 0.02). CONCLUSION:: In addition to existing evidence that postoperative orthogeriatric collaboration improves mortality and functional outcomes in older patients with hip fractures, this study suggests that allowing preoperative geriatric input in this model of care can produce even more superior results.
Authors:
Andraay Hon-Chi Leung; Tsz-Ping Lam; Wing-Hoi Cheung; Tan Chan; Pan-Ching Sze; Thomas Lau; Kwok-Sui Leung
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-13
Journal Detail:
Title:  The Journal of trauma     Volume:  -     ISSN:  1529-8809     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the Specialty Registrar in Trauma and Orthopaedic Surgery (A.H.C.L.), West of Scotland Training Programme, NHS Education for Scotland, Scotland, United Kingdom; Department Orthopaedic Surgery, the University of Edinburgh, Edinburgh, United Kingdom; and Department of Orthopaedics and Traumatology (T.P.L., W.P.C., T.C., P.C.S., K.S.L.), the Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
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