Document Detail


The orthogeriatric unit for acute patients: a new model of care that improves efficiency in the management of patients with hip fracture.
MedLine Citation:
PMID:  20544649     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We performed a prospective, quasi-experimental, randomised, interventional study comparing two models of care for patients admitted with osteoporotic hip fractures between February and August 2007 in a tertiary university hospital. The usual model of care was treatment of patients admitted to the orthopaedics ward, with consultation by the geriatrician (CG model). The study model involved admission to an acute orthogeriatric unit (OGU model), with joint care provided by geriatricians and orthopaedic surgeons which included immediate geriatric assessment, coordinated daily clinical care, weekly combined ward rounds, and joint planning of the surgical schedule, initial mobilisation, discharge date and destination. No differences were found between CG patients (123) and OGU patients (101) in terms of previous characteristics, number of patients surgically treated, functional level obtained, or discharge destination. OGU patients had earlier geriatric assessment (median 1 day, P25-P75: 1-2) than CG patients (median 4 days, P25-P75: 3-8), earlier surgery (median 5 days from admission to OGU, P25-P75: 3-6, versus 6 days in the CG group, P25-P75: 5-9), and had a shorter acute hospital stay (33% reduction, median 12 days in OGU, P25-P75: 9-14, versus 18 days, P25-P75: 13-23 in the CG group) and total (acute and subacute) hospital stay (30% reduction, median 14 days in OGU, P25-P75: 10-31, versus 20 days, P25-P75: 14-30 in the CG group). All these comparisons were statistically significant (p<0.01). The organization of an OGU in a tertiary hospital allowed hip fracture patients to receive earlier geriatric assessment and surgical treatment. Acute hospital stay was reduced by 33%, and total hospital stay was reduced by 30% with no differences at discharge in clinical and functional outcomes.
Authors:
Juan I González-Montalvo; Teresa Alarcón; Jose L Mauleón; Enrique Gil-Garay; Pilar Gotor; Alberto Martín-Vega
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Hip international : the journal of clinical and experimental research on hip pathology and therapy     Volume:  20     ISSN:  1724-6067     ISO Abbreviation:  Hip Int     Publication Date:    2010 Apr-Jun
Date Detail:
Created Date:  2010-06-24     Completed Date:  2010-10-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9200413     Medline TA:  Hip Int     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  229-35     Citation Subset:  IM    
Affiliation:
Department of Geriatrics, La Paz University Hospital, Madrid, Spain. jgonzalezm.hulp@salud.madrid.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Female
Geriatric Assessment*
Hip Fractures / etiology,  rehabilitation,  surgery*
Hospital Units
Humans
Length of Stay
Male
Osteoporosis / complications,  surgery*
Patient Care Planning*
Patient Care Team*
Preoperative Care / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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