| The orthogeriatric unit for acute patients: a new model of care that improves efficiency in the management of patients with hip fracture. | |
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MedLine Citation:
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PMID: 20544649 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Juan I González-Montalvo; Teresa Alarcón; Jose L Mauleón; Enrique Gil-Garay; Pilar Gotor; Alberto Martín-Vega |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
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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:
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Created Date: 2010-06-24 Completed Date: 2010-10-05 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9200413 Medline TA: Hip Int Country: Italy |
Other Details:
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Languages: eng Pagination: 229-35 Citation Subset: IM |
Affiliation:
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Department of Geriatrics, La Paz University Hospital, Madrid, Spain. jgonzalezm.hulp@salud.madrid.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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